Monday, November 18, 2013

HOW TO CURE SIBO, Small Intestinal Bowel Overgrowth: Step #4 Eat RESISTANT STARCH aka BIONIC FIBER (Guest Post: Tim/TATER)

Resistant Starch = Nondigestible Carbohydrates (BIONIC FIBER)
Credit: Harry Flint et al, Nature, 2012.

GUEST POST:  Tim (aka Tater)

Step #4. 
VERSION A: Green banana flour 1-3 Tbs + Raw PS (potato starch) + high ORAC green powder in 2 cups water
VERSION B: Raw PS (potato starch) 1-3 Tbs + Psyllium (if not allergic) 1 Tbs + high ORAC green powder (I like Amazing Grass, LOL) in 2 cups plenty of water

Step Four is crucial!  This is the food that will feed all of the beneficial bacteria you get from fermented foods and soil based organisms!  This step is missing in almost every other SIBO protocol, and the ones that include it--don't go anywhere near the lengths that Dr. BG and I did in our effort to feed gut microbes.  Many SIBO protocols, in fact, specifically EXCLUDE resistant starches and other fermentable fibers.  It is one of the most powerful combination of fermentable, butyrate producing fibers that we have taken to joshing around and referring to it as BIONIC RS.  It's not for sale, you make it yourself...Google it, you will find nothing!  Learn to make it and your gut microbiome will be your bitch.  Working for you instead of against you.  

If you've been reading AnimalPharm for the past few months, you know what resistant starch is.  Articles herehere, and here describe RS and it's amazing properties.  For a range of n=1 RS self experiments and FTA discussions, consider reading these links here for even more info. Photo credit: RESISTANT STARCH REVIEW.

Resistant Starch is a powerful prebiotic.  It has the undeniable abilities to:

- Selectively feed beneficial bacteria
- In the small intestine reduce pathogenic bacteria and out-of-place beneficial bacteria and decrease pathogenicity of virulent overgrowth
- Create a healthier large intestine through tightening of junctions, feeding of colonocytes, butyrate production, and forming biofilms impenetrable by pathogens

 One of, if not the best sources of RS is potato starch.  Potato Starch is cheap and easily found in any supermarket.  Bob's Red Mill sells potato starch for about $5 a pound which is more than a month's supply!  The supplement industry has not caught on to this powerful prebiotic, but you can bet they soon will!

A tablespoon of potato starch contains approximately 8g of RS.  Dr. BG recommends taking 1-3TBS per day or several times a day alongside the SBOs.  Taken together, the SBOs will be better able to survive the digestive processes which can kill most probiotics. 

To turn potato starch into BIONIC RS, add in some psyllium.  You may find the psyllium, especially if you are using psyllium husk, makes the mixture a lot more gummy, so you may need to put it in the blender with some milk, coconut milk, or water.  What we really love about the added psyllium is that studies have shown that when resistant starch and psyllium are used together, it completely floods the large intestine with butyrate.  Psyllium has a high water-holding capacity, and this may be why it is so effective at spreading the butyrate through the large intestine. The magic in psyllium is it's high mucilage content:  "Mucilage can be used in gastrointestinal inflammatory processes; associated to topical irritation agents. The mechanism of action is that mucilages cover the mucous membranes and prevent irritation of the nerve endings."  Psyllium ferments into butyrate, but is also an effective stimulant for the mucous layer that is vitally important to having a healthy gut.  It provides a home for many of the bacterial species we have introduced with the fermented foods and SBOs.  

From the study linked above:
 "Cummins et al indicated in human studies that an interaction between dietary starch and fiber occurred in large bowel fermentation and that starch was fermented in preference to fiber, suggesting that starch might exert a sparing effect on certain dietary fibers. Also, the present study clearly showed the interactive effects of Resistant Starch and Psyllium on large bowel SCFA and suggests that it is possible to maintain relatively high butyrate concentration in the distal large bowel by dietary manipulation."

In addition to potato starch and psyllium, and to further increase the BIONIC RS to stellar levels, add in a good dose of anti-oxidant rich foods full of polyphenols.  Once your gut is healthy, you will preferably get these compounds from real foods like berries, fruit, and numerous colorful veggies, but for now you want a concentrated dose.  Grace recommends Amazing Grass, a gluten-free powder that blends well with the potato starch and psyllium.  There are others on the market, just look for a high ORAC value and a good blend of fruits, vegetables, and herbs.  Polyphenols are just coming to light in their contributions to gut health.  This study looked into the contributions of plant polyphenols of gut microbiota health and concluded: 

"Polyphenols are extensively metabolized by gut bacteria into a complex series of end-products that support a significant effect on the functional ecology of symbiotic partners that can affect the host physiology."  


"The gut microbiota play a key role in modulating the production, bioavailability and, thus, the biological activities of phenolic metabolites, particularly after the intake of food containing high-molecular-weight polyphenols. In addition, evidence is emerging on the activity of dietary polyphenols on the modulation of the colonic microbial population composition or activity."

And here we see the profound effect of antioxidants on intestinal health:

"These results indicate that dietary antioxidants can limit epithelial cell death in response to oxidant stress. In the case of green tea and cat's claw, the cytoprotective response exceed their inherent ability to interact with the injurious oxidant, suggestive of actions on intracellular pathways regulating cell death."


A great way to incorporate all of these processes is to have a daily smoothie with potato starch, psyllium and an anti-oxidant blend.  Mix with milk, kefir, yogurt, water, or whatever you like.  Add in berries, fruit, or anything else that makes it taste how you like.  

137 comments:

Chris said...

1-3 Tbsp or tsp of psyllium? Most psyllium dosages recommendations are 1 rounded tsp with 6-8 oz water.

The Natural said...

I too believe that 3 TBSP of psyllium (=45g of fiber) would be way too much for most people. Psyllium has a water absorbing quality, therefore you must drink craptons of water with it. When I was taking psyllium alone, I'd get constipated if I did not drink at least 8oz of water per 1tsp. If you do the math, you'd need to drink at least 72oz to account for the extra 3tbsp of psyllium. The hydration needs will be even higher when you factor in additional potato starch.

Having said that, right now I am taking 1 TBSP PS + 1TBSP psyllium with approx. 36oz of water. While not constipated, the BM is not quick and easy. I could easily do with another 20 oz of water and that might help my BM. But 56oz of water at a time is very hard to drink.

T-Nat

The Natural said...

Hi Tim,
Could you please send me the 90 page document on RS to sdstk2000 at yahoo dot com.

Thanks in advance.

T-Nat

Michael said...

Thanks again Tim and Grace for the continuing series. Very good.

Been reading some Crohn's studies in the past few days and just wanted to share one of the most interesting ones I've come accross. It's actually pertinent to the topic at hand.

Translocation of Crohn's disease Escherichia coli across M-cells: contrasting effects of soluble plant fibres and emulsifiers

http://gut.bmj.com/content/59/10/1331.full

Effect of plantain/green banana NSP on bacterial translocation in Crohn's. This effect of plantains is separate of its conventional prebiotic potential in the colon. The authors state: "We feel that the ability of soluble plant fibres to block epithelial attachment and translocation by bacteria may be at least as important as any prebiotic effect, particularly in the small intestine."

Note also the contrasting effect of polysorbate-80 E433. Not good.

Anonymous said...

Sorry, but i'm not sure of what the recipe is, could you clarify how much green powder you use, as well as the teaspoon or tablespoon questions above?

Thanks!!

Tim Steele said...

Hey, guys - Sorry that didn't come out real clear as to the exact recipe.

This is what I think is the best possible use of the ingredients:

1-2TBS potato starch, 1 TBS psyllium husk, 1-2TBS of the green powder.

Mix in with milk, water, or whatever--even yogurt. Drink this concoction 1-3 times a day, several hours apart (like with meals) for several weeks. Increase the amounts of potato starch, but never to more than 4TBS at once.

If you feel like the psyllium husk is binding you up or you have had bad experiences with it, cut back or eliminate it from the mix.

Keep in mind, this is for people who have some serious healing to do! If you just want a daily dose for maintenance of gut health, I recommend getting 1-4TBS of potato starch, 1TBS of psyllium husk, and plenty of leafy greens/berries/colorful veggies every day.



Tim Steele said...

@Michael - Thanks for the study. Plantains have been used for stomach problems forever, it would seem. They have one of the highest contents of RS of any food.

Here's a similar study, sorry, abstract only: https://www.ncbi.nlm.nih.gov/pubmed/10647628

But literally thousands just like it. RS is the missing link in bowel health for sure. It's just until we came up with eating potato starch, RS sources were limited to potato salad and rice, which are pretty lame in terms of RS content. To get 40g, as is used in lots of studies, you need a concentrated source like potato starch.

Ms.Pearl said...

Tim,

I'm curious if chia seed can be substituted for the psyllium husks. It's what I have on hand, and like the psyllium, they form a mucilaginous gel.

Thanks,
Judy

Ms.Pearl said...

Tim,

I may have answered my own question. A cursory glance on the innertubes seems to indicate that the chia seeds have a lot of insoluble fiber compared with the psyllium husks (0%?), and it also seems that you would have to use far more chia to get the amount of soluble fiber readily available in psyllium.

Your take?

Thank you,
Judy

Tim Steele said...

Ms. Pearl,

I think chia seeds would be fine to take alongside RS. We picked psyllium because it was used in the studies, but I think any of the fibers that are high in mucilage would be fine.

Here is a list of mucilage containing plants in case anyone wants to use some of these:

The following plants are known to contain far greater concentrations of mucilage than is typically found in most plants:

Aloe vera
Basella alba (Malabar spinach)
Cactus
Chondrus crispus (Irish moss)
Dioscorea opposita
Drosera (sundews)
Drosophyllum lusitanicum
Fenugreek
Flax seeds
Kelp
Liquorice root
Marshmallow
Mallow
Mullein
Okra
Parthenium
Pinguicula (butterwort)
Psyllium seed husks
Salvia hispanica (chia) seed
Ulmus rubra bark(slippery elm)

Thanks for the great question!

I'd use a standard serving and see how you do.

Ms.Pearl said...

Hey, Tim,

Thank you so much for the reply. After discovering that chia apparently has much more insoluble than soluble fiber, I was curious about the effect on colon health. It has been suggested that insoluble fiber can literally "scratch" (my word) the large bowel and therefore may be detrimental to bowel health. All that being said, my gut is in better health than 99% of most of SAD Americans (not saying much!). I really don't have many issues, but I want to optimize my gut flora. So, I'm taking 3T potato starch with yogurt or kefir daily (about 3 weeks now) plus I make my own kraut (curtido, a salvadoran version), pickles, and kefir. At some point, I think my gut flora will start to sing...in a good way!

Judy

Ms.Pearl said...

P.S. Tim, how much are you paying for plantains up there in AK? My local discount grocer (laf) sells them for $.79 each.

Tim Steele said...

Judy - looks like you are doing everything right. Look into getting some psyllium husk in the future and using a bit alongside potato starch.

Plantains are cheap here, too. Probably closer to $1 each.

Dr. B G said...

Chris, T-Nat and Tim,

Thanks for your comments. The max I've used is ONE Tbs Psyllium so I edited. I agree. There's a threshold for what the bowel can tolerate plus lots of water is necessary. We don't want bowel blockages.

Amazing Grass is mainly good for flavoring. Because I'm in china I use about half to one tsp. I use also Acerola powder which is super high in antioxidant value, vitamin C and has a pleasant sour taste that masks the psyllium. If you riff it, I'd love to hear what works! I'd love to find a powered ume plum powder later as it has special gut benefits.

I'm on vacation in Geneva and Zurich, so apologize for all the slow responses (sorry Keith, I'm catching up)

G

Dr. B G said...

Michael

You're a mega super rockstar!!! Bisou bisou ;)

Tim and I suspected that but so nice to have clear confirmation. Thank you so much for the link forwarded.

Have you seen this response from Gelly, a UC survivor, on RS and her experiences? Hormones for happiness and reproduction are immensely ties to the HPA- thyroid- gonad- gut axis. My adrenals instantly perked up with enough soil based probiotics and Chinese tubers and fermented foods. What a difference for me -- no mire dizziness and daily high salt intake. The hormones improved significantly too.

http://chriskresser.com/poop-the-cure-of-the-future#comment-85412
Gelly
Last year after a several of hospitalizations for ulcerative colitis did a series of DIY fecal transplants using my 6 yr old nephew as a donor. He has never been on antibiotics and is healthy by all accounts. I couldn’t find a doctor to support me in the matter so I took my chances. The very next day after the first transplant I had more energy. I was extremely underweight and malnourished. While I am not perfect, for over a year I have had blood in my stool only once and my hormones are much more balance. My mood is more stable and my bowl movements are mostly regular with occasional loose stool. I no longer have seasonal allergies which were incapacitating in and of themselves. After every previous flare I would gain weight and would bounce back to my former overweight self (I didn’t this time and it seems my body has a new healthy set point). For almost a year I had no PMS symptoms and cycled painlessly, which was a life long problem. I don’t know what this connection is, only that my cycle was closely linked to my UC flaring. I have recently been experiencing more frequent mood swings with PMS and more frequent loose stool. I may repeat the treatment soon.

Dr. B G said...

(cont)

Adina August 11, 2013 at 8:11 pm
I should add I had been doing SCD/GAPS for 3 years without control of my symptoms (straying only to experiment with other protocols for a month or 2). One thing I found is I tolerate starches much better than fibrous vegetables. I am just now reading more about FODMAPS and I think there was/is an issue with some of these, fructose for sure. I was tested for SIBO (breath hydrogen test) and it was negative. I want to understand all of this better!

REPLY
Gelly August 12, 2013 at 9:19 am
Adina – If you do it again (or even don’t) I can highly recommend increasing the resistant starch in your diet to about 10-20g or more per day. I have had really bad intestinal troubles my whole adult life, short of IBD/Crohn’s–but doc said it was coming. Last fall I had my third colonoscopy–they found nothing…again. Doc mentioned more fiber and resistant starch. I had gone the high fiber route before with disastrous results, but had never heard about resistant starch. I did some googling and came across this guy on a website called Free the Animal doing a lot of research on resistant starch.

You can get resistant starch from easy foods like green bananas and cold potatoes, but since I didn’t like those very much, I started just using potato starch, which apparently has about 8g per tablespoon. I take 2-3 tablespoons of the stuff every morning with my breakfast smoothie. I can say for the first time in years that my intestines have never felt better and I think I may finally by doing something that is making a difference.

In the 4 months I have been doing this, I have not had diarrhea, constipation, or heartburn like I used to have almost every day. I think my last colonoscopy prep wiped out all my gut bacteria and eating resistant starch as they repopulated caused the good bacteria to grow faster than the bad stuff, that seems to be the theory anyway.

Maybe you would benefit from more resistant starch, too.

Not everyone likes the guy who runs this website, he’s kind of ‘out there’ on social issues, but his stuff on resistant starch is all rock-solid and research based, not just a crappy diet he’s trying to sell. Here is a link to latest article, follow the links and be sure to read all the comments.

http://freetheanimal.com/2013/08/how-resistant-starch-via-potato-starch-and-beans-helped-a-type-2-diabetic.html

Dr. B G said...

Michael,

What are your core body temps? This is truly the best metric to assess the HPA axis. The thyroid and adrenals are always in parallel like electricity and network circuits. The thyroid is more controlling for the absolute temp and adrenals more for temp stability and regulation, per Bruce Rind and my experiences and observations.

For me I randomly started the PS. Had no TMI or obvious changes initially when I added it to the normal pysllium and Amazing Grass/Acerola regimen. I overdosed once purposely on 4-5 Tbs to see what it would do and had the extreme heat that others reported at the FTA threads and others have reported. So then I split batched two tbs PS twice daily and was so warmly surprised that I don't get as cold in the evenings when the temps drop in Shanghai (pun)! There is a time lag which I haven't figured. Maybe others can chime in. The butyrate or other volatile fats don't appear for a lag but I haven't been too scientific to watch it.

Anyway, because PS is like bionic food and super fertilizer for the keystone species in the the gut, there's a lag before the adaptations in the 'gut ecosystem'. This is reported in the literature. Don't give up but the critters work best in thelarge intestines. If they're not transported or making it there, instead landing inappropriately the small intestines, the location isn't ideal for the fertilizer to work, no? It's the wrong population and wrong place to feed as well. Many adaptations occur
--bile acid turnover
--less secondary bile acids
--tight junction integrity
--resurfacing of mucin interfaces
--better secretion of fucose and other glycans on the microvilli tips which serve as food and growth messages to beneficial symbionts

Here are some time to adapt studies:

Influences of dietary adaptation and source of resistant starch on short-chain fatty acids in the hindgut of rats.
Henningsson AM, Margareta E, Nyman GL, Björck IM.
Br J Nutr. 2003 Mar;89(3):319-28.

Br J Nutr. 1999 Nov;82(5):419-26.
Enhancement of butyrate production in the rat caecocolonic tract by long-term ingestion of resistant potato starch.
Le Blay G, Michel C, Blottière HM, Cherbut C.

Keith Bell said...

It should be noted Grace chose to break down the SIBO acronym as Small Intestinal Bowel Overgrowth instead of the usual Small Intestinal Bacterial Overgrowth. Though redundant, it's a good choice because too much focus is now placed on bacteria and not enough on fungi. Indeed, the gold standard breath tests to diagnose SIBO fall short in discerning fungi from bacteria (fungi also make hydrogen gas). Then people are prescribed antibiotics such as Rifaximin only to cause further imbalance. Not many people choose the stool and urine testing which does a much better job identifying the culprit. Still fewer do things such as blood ethanol testing to discern fungal overgrowth.

Looking at Grace's charts generously made public along with detailed discussion of her progress, she's been able to balance seemingly by two major wins: 1) removal of titanium dental implants which were likely killing/compromising important strains of bacteria which would normally control yeast, and 2) high-powered probiotics such as Natren which control yeast (bacteria eat yeast, that's part of the microbial food chain).

Now she's pioneering use of SBO probiotics in attempt to bust fungal biofilm. It's a similar strategy as eating dirt practiced by people for centuries. There's even a new restaurant in Japan incorporating dirt in all their dishes. It will be interesting to learn how this strategy pays-off. WIll the SBOs really be able to bring down still high levels of fungi? Can they really get under the surface so that the chronic problem can be resolved?

I'd bet more than half those diagnosed with SIBO actually have SIFO (fungal overgrowth). The fungi crowd-out vulnerable gram-positive bacteria such as lactobacillus and bifidobacteria, allowing gram-negatives such as e. coli and clostridium to flourish. By focusing on yeast control, the bacterial balance changes to a more normal state as evidenced by Grace's before and after charts. To really get under the surface and attack the chronic issue means enhancing innate immunity. That's why I'm a fan of things like OptiMSM which raises pH to kill fungi (sulfur alone does it). And also niacinamide, a form of vitamin B3 which fuels NAD to raise ATP which stimulates macrophage activity. NIacinamide has also recently become known as antifungal. Nicotinamide is niacinamide, same thing, different name. http://www.sciencedaily.com/releases/2010/07/100708141617.htm

Anonymous said...

Tim,

Good stuff. Couple questions...

1) The biggest obstacle for me in going all in with RS has been the gas. You seem to say that it's because of a lack of bacteria. But isn't gas a byproduct of bacterial fermentation? Or is it just the wrong bacteria that are doing the fermenting?

2) What do you make of Paul Jaminet's assertion in his book that too much fermentable fiber for people with leaky guts could lead to "endotoxemia"?

Tim Steele said...

Anon -

1) Gas is a funny thing. Gas is a normal part of life, but on a SAD diet some people rarely experience it except after eating 'bad' food.

When adding in RS, more gas is to be expected. Normally after a few weeks, most people report that their gas is not bad and not 'noxious', just airy.

For the first few weeks, many people report, and I can confirm, lots and lots of gas! Almost comedic levels. This usually goes away in 3-4 weeks. If it's a problem, cut waaay back on the dose, like 1/2-1 TBS of potato starch and add back in as you can.

If you are experiencing bloating, painful gas, very odoriferous gas, or anything else completely and obviously bad--you definitely have problems with gut microbes! The answer isn't complete avoidance of RS, but to find a way to re-balance microbes...lots of fermented foods, probiotics, starchy tubers, anti-oxidants, etc... then hit the RS hard.

2) I love Paul J, his recommendation might be right for overall fiber, but not for resistant starch. RS has been shown over and over to repair leaky gut through stimulation of microbes and butyrate production for epithelial cell repair. Paul wasn't really looking very hard at RS, as was no one else, when he last updated the PHD. Although, his recommendations for RS are way more thorough than anyone else!

Kate said...

Thanks for this post, I was wondering about the psyllium. I had been mixing a little inulin with my PS, but I don't think it is muciligious. I have some slippery elm powder, maybe I'll try that.

Keith Bell said...

Have you heard about retrogradation where temperature affects quality of resistant starch (RS)? Maybe this is origin of the expression "cool beans." Basically, cool yer beans and potatoes for optimal RS. See here:
http://books.google.com/books?id=bKVCtH4AjwgC&pg=PA458&lpg=PA458&dq=retrogradation+starch+refrigerator&source=bl&ots=qWOEldN4ph&sig=p3YPiaze2jRq3ZMtBYQVBBaU7jc&hl=en&sa=X&ei=5Z1tUv6aM8Ww4AOUkYCgDg&ved=0CGcQ6AEwCTgK#v=onepage&q=retrogradation%20starch%20refrigerator&f=false

Tim Steele said...

@Keith - The deal with heating and cooling is a bit of a complicated science.

We are dealing with two types of RS...RS2 and RS3.

RS2 is what is in a raw potato, green banana, and raw starches. It is resistant to digestion because of it's shape, size, and physical characteristics. If you look at it under an electron microscope, it appears to be built in layers of concentric circles, like a pearl around a grain of sand. This structure is impervious to digestive acids in the small intestine, but gut microbes readily attack it and ferment it into short-chain fatty acids in the large intestine. When heated above a certain threshold, these starch granules swell and burst, turning into readily digestible starches called amylose and amylopectin.

RS3 is formed when amylose starch (but not amylopectin) cools. It gels together under heat, and when it cools, it forms a crystalline structure known as retrograded starch. This retrograded starch is again in a form that stomach acid and normal digestive processes can't break down. It is also great food for gut microbes. When re-heated, the crystalline structure remains, even possibly gaining, in crystalline structure. This is especially true if the reheating is done in a very hot, dry manner, such as frying in hot oil or baking at a high temperature. Boiling in water or steaming will not produce these results. With each subsequent heating/cooling/reheating cycle, the RS3 value gets higher and higher, but never as much as in the first cycle--it produces diminishing returns.

Evolution-wise, this makes good sense. We evolved eating raw tubers/starchy plants and later when we learned to cook, we got even more RS. Both types of RS are fermented primarily by beneficial bacteria and produce SCFA, but each type of RS is fermented by different microbes which is why I think it's important to eat a variety of RS sources--raw starch AND RS-rich foods AND cooked and cooled starches.

Michael said...

Grace,
You are very generous with your time, writing both funny and deep comments. There's just so much to think about here.
I'm very pressed for time and going away for a few days to the big city. Will get back to your comments next week.

Great comments by Keith, too. Btw, apparently there are several of these restaurants in Japan, all in Tokyo I believe. Unfortunately I'm never in Tokyo when I do go to Japan.

Thanks again Grace & Tim.
Just love this blog
:)

The Natural said...

Speaking of SBO's,
It is probably my wishful thinking but is there any possibility that
Diatomaceous Earth
could contain any beneficial SBOs. It primarily consists of fossilized remains of diatoms, a type of hard-shelled algae. 80% Silica, 5% sodium, 3% magnesium and 2%iron. I am considering adding this to my Potato Starch + Psyllium Husk shake mainly for the mineral content esp. Silica.

There are some very positive anecdotal reports on DE usage at the Low Carb Friends...some excellent results on hair, skin and nails DE link on Low Carb Friends

It is alkaline at a pH of 8 so it should help mitigate the potential acidiosis from regular PS and Paleo diet.

BTW, it is excellent for pest, bug and flea control and a natural pesticide for the garden; so Tim could use some in his backyard veg garden :-)

Let me know what you guys think and if you have come across this in your research.

Tim Steele said...

T-Nat - I have used DE in my garden before, though not since moving to AK--we just don't have the soil pests like they have in warmer places.

As far as eating it, I have read lots of good things about it, but never tried. If I knew I had a specific parasite that could be killed by DE I would definitely try, but to just add it for the heck of it, I wouldn't do.

For silica, we have a plant that grows here called horsetail. I put it in salads or just eat it when I see it--it's a common weed for us. Most silca supplements are made from horsetail. DE is also a good source of silica, so I could see eating DE for that reason.

Lola said...

I just spent a ridiculous amount of time reading through everything in the last few days. I had just been starting to add in RS to my diet after a year of Paleo Autoimmune protocol/GAPS diet experimenting and so Immediately added in Psyllium and Soil based probiotics and upped my RS in the morning. I'm feeling great after only three days of following this new protocol. Strange that starch could fix what such rigorous food restrictions haven't been able to. I have Scalp Psoriasis, Chronic Fatigue, debilitating headaches and mild RA. I'm hoping that I can actually heal my poor gut. I'm optimistic. Just wanted to stop in and thank you for posting this information. It's very much appreciated.

Anonymous said...

Great series of posts. Thank you so much! A question about the extended uses of SBO's... do you think that they should be a staple of the diet, not just for curing gut issues? What do you think about regular supplementation, especially in those whose diet contains minimal dirty organic veggies? Lauren

Tim Steele said...

Lola - I'm optimistic, too. Everyone's first reaction to potato starch is that it's too simple (Right, Grace?). That's the beauty of it. I got my American Gut Project results back the other day--my bifido count is 19 times the test pool average! Bifido is what you want...it's what you pay for in probiotics and yogurt. A gut full of bifido is protective of other beneficial microbes and death to pathogens.

Keep us posted on your issues. I can see a belly full of potato starch helping all of them.

Karen said...

Would a protocol like this be safe for a 10 year old child? My daughter has some definite gut issues (exposed to antibiotics while nursing and in early infancy). Also had to stop nursing at six weeks, then formula:(

Anonymous said...

Hi!

Couple of questions:
- I've gone through most of the studies on RS, but I've not found any human studies that actually investigate changes in the gut microbiota after RS cobsumption for some time.. are there any?
- I ate RS from potato starch for about 5 weeks, but the gas never subsided... Perhaps I'm missing some gut microbes or something, but I'm actually eating several types of fermented foods and taking both SBOs and regular probiorics.
- Are there any studies showing that bifidobacteria are able to ferment RS in the colon?

Thank you for a very interesting series on SIBO!

Unknown said...

Hi Tim
You mentioned that boiling potatoes will not allow formation of rs3. Will microwaving potatoes to initially cook allow for effective formation of rs3. Thank you.

Tim Steele said...

Karen - Let's see what Grace says, but I think most of this protocol would be suitable for children. Kids probably should be encouraged to play outdoors and get dirty as opposed to lots of probiotic supplements, though. Kids are very resilient, I know some other folks that feed their kids yogurt w/potato starch every day, and also another good friend whose kids put potato starch in their no-bake cookies.

Let us know how she does!

Tim Steele said...

1st Unknown - Lots of studies like you asked about, I'll post at the end. If you are getting gas for 5 weeks, drop down to 1/2TBS a day or like 1-2TBS every couple days. The potato starch is just showing that there is a problem, probably a lack of certain microbes, like bifido. Don't give up on it and keep eating fermented foods and taking probiotics, the good microbes will grow and stick around if you feed them enough microbe food.

Studies on bifido increasing in humans w/RS:

Using RS from Lotus Seed: http://www.ncbi.nlm.nih.gov/pubmed/24056635

Importance and preference of RS by bifido:
http://www.nature.com/ismej/journal/v6/n8/full/ismej20124a.html

Importance of RS and Bifido on human infants:
http://journals.lww.com/jpgn/Fulltext/2006/11000/Human_Faecal_Microbiota_Develops_the_Ability_to.7.aspx

Rat study, but shows undeniable attraction between RS and Bifido:
http://jn.nutrition.org/content/135/5/996.full

A table from a study that outlines the major gut microbe changes during prolonged RS feedings in humans...look closely at column labeled 'Bacterial changes detected':
http://www.nature.com/nrgastro/journal/v9/n10/fig_tab/nrgastro.2012.156_T1.html

Let me know if you have trouble with any of the links!

Tim Steele said...

2nd Unkown - RS3 only appears when potatoes are cooked and then cooled.

When cooked using drier methods (baking, frying) more RS3 will appear than if cooked by boiling or steaming.

But the difference is slight. Cook your potatoes however you like, eat some hot, save the leftovers--even freeze them. Then you can reheat these cold-stored potatoes and there will still be RS3 in them, they don't have to be eaten cold.

Same story with rice and beans.

Tim Steele said...

Lauren - I think that if you are eating plenty of good veggies and supplementing a bit of potato starch or other RS, then you only need to take the SBOs for a short time, like maybe buy a bottle and use them up over a month or so. Once your gut flora gets established, I think natural SBOs will set up shop and you won't need supplements at all. For people who have taken antibiotics recently or are having gut issues, the supplements are more important.

Anonymous said...

Tim... 'no bake cookies' with PS?!? Recipe please :) Lauren

Tim Steele said...

OK. But I warn you, they are too good (eh, Grace?)

In a pan on stove, melt 1/4 cup butter, 1/2 cup milk, 1/4 cup cocoa powder, and 1 cup coconut sugar or sweetener of choice. Add splash of vanilla. Take off heat, stir in 1 cup raw oats, 1 cup coconut flakes, 1/2 cup almond butter. 1/2 packet of unflavored gelatin. Stir well, and when cool add in 1 cup of potato starch. Make sure it has cooled to 120 degrees or lower!

Stir, if still fairly soft, add more oats or coconut or potato starch until it is pretty stiff.

Spoon onto wax paper and put in fridge to harden.

Unknown said...

Having recently developed gut problems, I was all set to start taking soil-based organisms, but was warned strongly not to take them by a certain autodidact gut guru who claims that they can become opportunistic and that if they do, antimicrobials are almost useless against them. He relates the story of a friend who became deathly ill post abdominal surgery because of a colony of endospores taking up residence in his gut from all the soil-based organisms he had been taking. This person claims that his friend was only healed by following a protocol using biofilm chelators and aggressive antibacterials.

I've really become desperate lately because my pain is not abating. I'd certainly like to start this protocol, but am a little anxious.

Mike

Tim Steele said...

Mike - Notice that Grace said SBO's 'IF NOT IMMUNE COMPROMISED' or something like that.

I tried hard to find a reason to NOT take SBOs. There were a flurry of articles around 1997 that warned against SBOs because of the spore-forming nature and ability to become pathogenic, but aside for people with HIV or maybe recovering from surgery, there is no reason to fear the SBOs in the supplements recommended here. More than likely, you are in contact with these SBOs every day, anyway--they are THAT common.

The reason we SHOULD be taking them is because these microbes are an important part of a health microbiome, when taken in supplement form along with fermented foods and potato starch, they will have the best possible chance to establish meaningful colonies in your gut.

Here is a link to Mark Sisson's store with a cool video and good description of SBOs:

http://primalblueprint.com/products/Primal-Flora.html

Also, Grace wrote a good bit here, too:

http://drbganimalpharm.blogspot.com/2013/09/korean-pepper-paste-burns-visceral-body.html

pipparoni said...

Tim/ Grace
Thoughts on Josh Rubins Amasai product?

Tim Steele said...

pipparoni - Amasai is probably pretty good stuff, supposedly from grass-fed cows, but looks like just kefir to me. If you can't make your own, it's probably top-notch. I prefer to make my own, it's easy, and I also like to make beet kvass, sauerkraut, and am just learning about kombucha.

Seems like Jordan Rubins is a good salesman.

Here's a link if anyone's interested:

http://trylivingorganic.com/2012/03/27/amasai-beyond-organic/#more-725

pipparoni said...

Tim
Just had my first beet kvass, store bought but will start making my own, My digestion feels good.. =) yes he is a good saleman isn't he !

Kate said...

@ Pipparoni, my 2 cents worth on Amasai. I have ordered the plain version twice. Although I hate the way it is marketed, it is very tasty. I have experimented with homemade sauerkraut, beet kvass, kombucha, and Kefir. I can tolerate a little sauerkraut, but the latter all equal migraines. Maybe some kind of histamine issue. Anyway, Amasai is the only fermented product I have found that does not cause any issues. I'll have to say it really annoys me that he won't divulge the critters he uses.

pipparoni said...

Thanks Kate

Dr. B G said...

Kate,

Thats is so interesting your reaction to fermented foods. When I had massive candida/titanium/mercury problems I was intolerant to all fermented foods also, but no headaches. If you suspect a fungal overgrowth, then avoidance of fungal products and fungi/mushrooms is prudent until the microbiota shift to healthier colonies and balanced ecosystem. Fermented products can have yeasts and fungi which release fungal growth inhibitors, besides haroring mycotoxins which add to one's load if already overburdened with mycotoxins. You the body is already over secreting histamine from fungal/microbial overgrowth, these wonderful fermented products, mushrooms, soy sauce, etc just add to the tipping point.

For me, I found eating heirloom tubers (purple, white mountain, yams, sweet potatoes) and Bacillus licheniformis + Clostridium butyricum to be the absolute 'cure', after removing the initial trigger -- mercury/titanium.

The role that SBOs that I believe SBOs have is that they improve the immune system (like the SFB Type 1 diabetes study models) as well as secrete things which improve the ecosystem toward something more balanced, as long as they are FED RIGHT. Like with RESISTANT STARCH, their optimal bionic food.

SBOs secrete
--antifungal compounds
--enzymes which can degrade food allergens (gluten, casein) and carbs
--BIOFILM BUSTERS

Candida can shift to aggressive and pathogenic life forms. Also they live in biofilms which are thick, slimy fortresses. Hidden and protected from our immune system and degradation. One thing wonderful about an ecosystem is that every species and thing has a role and each role is important.

After I started the SBOs, my food intolerance nearly 99% went away. I used to be able to pound breve's and latte's but could not for the last 2-3 years without bloating and hand joint pains. NOW! No problem. Yeast is a much larger problem because of the existence of so many gut disruptors and lack of RS + SBO.

g

Dr. B G said...

Thanks for your awesome input Tim and Pip~~!!! U GUYS ROCK!!!

Dr. B G said...

Mike,

I had exactly the same concerns. Surgery and any hospitalization is EXTREMELY STRESSFUL FOR THE HUMAN BODY. Stress as you know is bad. Stress in animal studies has been shown (have to dig out the citation) will release high cortisol, shift the biome to pathogenic E coli and down shift good Bifido, lowers immunity, and lead to significant intestinal permeability. When we give prednisone or other corticosteroids (for RA, allergies, asthma, autoimmune diseases) as pharmaceuticals, a high incidence of ulcers and mucosal permeability occurs. Bad, no? the treatment worsens the ROOT CAUSE. lol

Other immunosuppressive situations are:
--low WBC, white counts
--chemotherapy
--post chemotherapy
--mercury
--chemotherapy (did I mention?)
--ICU hospitalization
--organ failure
--drugs: immunosuppressants, cortisone, prednisone, etc

Previously I responded to Keith Bell:

"Regarding potential problems with all probiotics, I concur. In immunosuppressed individuals, there is a danger for bacteremia and sepsis. This is seen with any probiotic including Lactobacillus and Licheniformis.
http://www.ncbi.nlm.nih.gov/pubmed/23462584
http://www.ncbi.nlm.nih.gov/pubmed/22544343
http://www.ncbi.nlm.nih.gov/pubmed/23792476

Before I started on extended courses of Prescript Assist, I spoke with the owners of PA. Jarrod (co-CEO) and I used to do Crossfit at the same Walnut Creek gym. There are no reported adverse effects that we are aware of. There is one study of one year's length with no reported adverse effects that I read."

Clin Ther. 2007 Jun;29(6):1153-60.
Prescript-assist probiotic-prebiotic treatment for irritable bowel syndrome: an open-label, partially controlled, 1-year extension of a previously published controlled clinical trial.
Bittner AC, Croffut RM, Stranahan MC, Yokelson TN.

OBJECTIVE:
The aim of this study was to extend a previous 2-week assessment of a probiotic-prebiotic complex in patients with irritable bowel syndrome (IBS).
METHODS:
In this open-label, partially controlled, 1-year (14 [2] months) extension study, data were collected from patients with IBS who continued treatment following a 2-week study of the efficacy of the probiotic-prebiotic complex. Data were collected at 2 and approximately 60 weeks after the end of the original study.
RESULTS:
A total of 25 patients entered the 2-week extension and 22 completed the approximately 60-week follow-up study (20 women, 2 men; age range, 20-70 years; all white). Results in the control group 2 weeks after crossover to treatment were similar to those from the original study, with reductions in IBS subsyndromes, as follows: general ill feelings/nausea (P < 0.001), indigestion/flatulence (P < 0.001), and marginally colitis (P < 0.03 [1-tailed]). Treatment was associated with a continued reduction in general ill feelings/nausea at 4 weeks (P < 0.007). At >or=52-week follow-up, the rate of remissions was 81.5% to 100% (P < 0.003).
CONCLUSION:
Based on the results from the present 1-year extension study, treatment with this probiotic-prebiotic complex may be an option for short-term (2-4 weeks) and long-term ( approximately 60-week) reductions in IBS symptoms.

Dr. B G said...

THANK YOU SO MUCH TIM~!!!

Tim's RS NO BAKE recipe is a favorite in our household (be aware of the TMI fartage!). it is super high in fiber NSP + RS.

My child used instead sesame paste which is considered a 'superfood'. This recipe was absolutely addictive as the sesame just melds well with chocolate and oats and vanilla...

+++If you have low iron or low zinc/mag, consider soaking the oats overnight in yogurt or kefir to lower the phytic acid. If you have hemochromatosis, go for it!!

Dr. B G said...

Michael~!

Hope you have safe and wonderful travels. LOVE JAPAN!!!


T-Nat,

Diatomaceous earth is awesome. Like anything (supps, clay, charcoal, people) you need to make sure it's not toxic.

Some diatomaceous earth is arsenic-contaminated. Recently German beer was founded to be heavily laced with arsenic due to the filtering process that utilized contaminated diatomaceous.
http://www.npr.org/blogs/thesalt/2013/04/08/176587506/arsenic-in-beer-may-come-from-widely-used-filtering-process

I'm not certain where all of earth's natural arsenic comes from. In the USA map, arsenic is heavy in our water/environment across the states (see Deborah Blum's Elemental blog).

http://www.wired.com/wiredscience/2013/09/arsenic-nation/

Dr. B G said...

Keith Bell,

How do YOU rock so hard...??!

How are you so profound in your observations and knowledge base??!

I think you have a very lucky view point to see things from the microbe's world view...

Everything you say is true. Every word, every phrase. The only thing that controlled sysmptoms and sanity during CFS was chronic routine use of fluconazole. That's no life or solution, no?

We are in symbiosis with the microbes and as you stated the bacteria and in symbiosis with fungi in our guts. I think it is quite easy for fungi to flourish when the ecosystem breaks because fungi are eukaryotic like our human cells... our immunity is impaired to fight fungi. Our higher sustained body temps were the main safeguard during evolution against fungi. In CFS, our body temps go down --- this is of fungal origin. They can release toxins which block thyroid receptors and decrease metabolism which subsequently lead to lower body temperatures. Clever nifty little F*KCRS.

http://drbganimalpharm.blogspot.jp/2012/11/mitochondria-fuel-fluxxx-and-heat-nsfw.html

I have to check out niacinamide and MSM.

Thank you so much for all of your responses and insights~ Mr Bell! I adore so much you and your doggie.

Dr. B G said...

Mike,

One more additional thought. In abdominal surgery, it is standard protocol to use antibiotics. Guess what? This wipes out further any commensal organisms that would provide the right environment for appropriate population of the gut. Additional antibiotics select for fungal and pathogenic overgrowth in the gut. This is the largest problem facing us now and most fungi can't be cultured or grown out. Yet if i look at someone and listen to their symptoms, it's quite apparent when fungal overgrowth is implicated.

Here is one study that uses a bunch of gut disruptors (hydrocortisone, chemotherapy, B vitamin blocker/immunosuppressant +!antibiotics) then inoculates with candida. Dissemination of candida to other organs occurs when the white count is low and greater the damage to mucosal integrety (eg gut leakiness).



Kansenshogaku Zasshi. 1989 Jan;63(1):44-51.
[Effect of antibiotics and anti-cancer drugs on gastrointestinal infections and dissemination by C. albicans in mice inoculated orally with C. albicans].
[Article in Japanese]
Suzuki H, Nakamura A, Miyaji M, Nishimura K.

The authors studied the effect of antibiotics, hydrocortisone and anti-cancer drugs on gastrointestinal infections and dissemination by C. albicans in mice inoculated orally with C. albicans. The mice were given orally, vancomycin, amikacin and polymyxin B, and they also were injected with ampicillin and gentamicin. Hydrocortisone, cyclophosphamide (CPA) which causes leukopenia and neutropenia, and methotrexate (MTX) which injures the mucous membrane of the gastrointestinal tract were injected to the mice. In the mice treated with antibiotics and anti-cancer drugs, and inoculated orally with C. albicans, the colony forming units of the feces conspicuously increased. Gastrointestinal candidiasis was frequently observed, particularly at the cardia and the cardio-antrum line of the stomach of these mice. In addition to these sites, gastrointestinal candidiasis was observed at the antrum and the small intestine of the mice injected with MTX. C. albicans was frequently recovered from the livers and lungs of the mice treated with antibiotics and MTX + CPA which cause leukopenia, neutropenia and the damage of mucous membrane of the gastrointestinal tract. It is suggested that the threshold gut population of C. albicans is a determinant for gastrointestinal candidiasis, and that leukopenia, neutropenia and the damage of mucous membrane of the gastrointestinal tract are important factors for dissemination by C. albicans from the primary gastrointestinal lesions.

Dr. B G said...

Keith~~!!

Beans are cool and UR HELLUV COOLER ;)



Lola,

Do you blog and garden? I love lush stills that you posted!

If those simple measures don't work please consider deeper gut disruption like Protozoa, worms, and parasites. My kids and I all have parasites and I think these are far more common than any public health agency wishes to declare. Good luck with recovering the gut. Thank you so much for letting us know your progress!!

Have you heard of Diana at MY RA Diary? She's my new buddy. She has pretty done the 8 steps (including merccury removal) and addressing parasites. I think you'll love her recovery story.

http://www.myradiary.com/

G

Dr. B G said...

Karen,

I'm sorry for the slow response. YES. Absolutely. Even my Seven year old niece Jillian has been doing this for years (no PS, but yams, beans, brown rice, cellophane noodles, etc).

I talked about Jillian at the AHS 2011 presentation on gut health. My sister recovered her from autism 95-98% with this protocol. Autism is a broken gut. She used paleo, beans and starches, Threelac SBO probiotic, clay/charcoal, plant antioxidants like pycnogenol and grape seed extract, and chelation.

My children and I recently did the ONE and GI function stool test which identified parasites and overgrowth in each and all of us. We are doing much better after using rounds of antimicrobials/anti parasitic botanicals and adding the vital SBO probiotics. The kids only do RS cookies now but we eat purple tubers and yams daily. For me adding the RS by PS maintains all the health reversals and after about 3-4 wks I noticed more core warmth and higher temps (I run cold my whole life despite nature throid).

Hope that helps
G

Keith Bell said...

omg, grace, you bring me to tears. Check into boron, too, there's a lot of power in it. Boron deficiency may be a bigger deal than we know. And I wonder if nystatin, said safer than fluconazole, i.e., doesn't cause liver damage, wouldn't be a good combination with SBOs. Then there are things like colloidal silver and grapefruit seed extract, but I like the expression "you can't kill your way to health," so raising innate immunity gets my vote. It seems like a more hopeful way to live; becoming part of the web of life. Boron happens to raise immunity while also kicking ass, but like most things, you can have too much of a good thing. Same with selenium, which fungi are known to soak up leading to deficiency. Fungi are actually tools of bioremediation for selenium toxicity in soil and lakes due to mining pollution. Zinc picolinate is said to be easiest on the gut and best for systemic bioavailability. I've read it takes two months of zinc supplementation to balance copper, allowing copper to do its job killing yeast. Zinc deficiency is probably the world's #1 mineral deficiency. A zinc molecule is required at the base of the vitamin D receptor for vitamin D absorption where D is about intracellular calcium absorption to stimulate macrophage activity to balance flora (that's innate immunity!). Another huge aspect of zinc is how it holds insulin together in storage and somehow prepares it for activation to heal the gut lining. Bacteria are known to stimulate release of insulin from intestinal epithelial cells (insulin is hardly just about the pancreas, it's also made in the brain . . . or do you believe your brain is sterile?). Unfortunately, all these minerals may be lacking in today's food supply because of poor soils. The purpose of minerals is to activate enzymes where enzyme deficiency es no bueno. From Palm Beach County With Love. http://www.zincsaveskids.org/

Melissa Mcewen said...

Tim, I'm interested in this stuff but I'm concerned about over-supplementing RS if I'm already getting enough. If potatoes are cooked and cooled and then re-heated a bit is the RS destroyed? For example, a batch of brandade.

What about traditional pounded starch dishes like mochi or fufu?

Tim Steele said...

Hi, Melissa! Big fan here!

In your 'Human Colon in Evolution Series' Part 4, you showed a table of butyrate production in response to different fiber types, with RS, pectin, and gums leading the pack. This article was one of the reasons I started digging into RS, so thanks!

To answer your question on over-supplementing, I am 100% positive you cannot over-do RS.

There may be an upper effective limit, somewhere in the range of 40-60g/day, but the loss of effectiveness is due to the inability of gut microbes to process more than 40-60g at one time. In studies with massive feedings (100g+RS), lots of the starch granules are found in the feces meaning it is simply passed through without being fermented.

Grace has probably come the closest I've seen any get to a meaningful amount of RS using real foods, but most people don't have access to unlimited amounts of the roots and tubers she was using to increase her RS intake.

Eating as you suggest, cooked and cooled potatoes, will get a bit of RS, but not much more than is found in SAD. Mochi and fufu would be better. Dried plantains, green bananas, legumes, rice, etc. all add RS to the diet, but unless you are eating several pounds of these foods, you are still lacking enough RS.

Additionally, RS comes in 4 flavors (as you know). RS from cooked and cooled food is all RS3, the RS found in green bananas, dry plantains, raw potatoes, and potato starch is RS2. It's the RS2 that is nearly wholly missing from all western diets, including paleo. RS2 and RS3 are fermented by and cause increases in different populations of gut bacteria. That is why I say it is so important to eat RS-rich foods (RS3) AND target RS2 by eating green bananas,dried plantains, and supplementing with raw potato starch to fill the gap.

In most of the human studies that used RS2, they found the biggest changes to gut microbiota occurred with RS at a rate of about 30-40g/day for 3-6 weeks.

I can guarantee no American eats 30-40g RS/day! I have never seen a hint of a conclusion that there is an upper limit related to safety or heath.

Not sure if you are a fan, but I have been writing a lot on Free The Animal relating to my high RS consumption over the past year. I did an American Gut test recently and posted the results in this blog: http://freetheanimal.com/2013/11/resistant-american-comparison.html

Also, lots of good info there on RS--probably more than anywhere in the world, actually, including this Master RS List I made last summer...http://freetheanimal.com/wp-content/uploads/2013/08/Resistant-Starch-in-Foods.pdf

Bottom line on my Am Gut results, average bifidobacteria in 5000 or so other samples was less than 2%, mine was more than 12%. Americans are wasting $Billions on yogurt and probiotics as long as the bacteria are being starved of RS and other fermentable fibers.

Hope that helps--I'd love to get you on the RS bandwagon again!

Tim Steele said...

Melissa - One other thing. I wanted to share this table of SCFA produced by fibers.

If you look at Table 2 in this study,

http://onlinelibrary.wiley.com/doi/10.1002/star.201000099/full

You will see that pectin and gums are fermented almost completely into acetate, where RS is fermented into equal parts acetate, propionate, and butyrate. This is clearly where RS beats Pectin and gum, but I like the thought of including many different fermentable fibers in a good gut diet.

If you haven't seen the review paper I linked above, you will like it very much! 100's of blogs could be written from it (hint, hint)

Melissa Mcewen said...

Thanks Tim, I think I was interested in it but lost interest when a lot of the research is so outside of the context of actual food that I felt it would be difficult to translate into dietary action.

As you said, it's hard to get the amount that some of the studies show is beneficial without some kind of supplementation. I'd be curious to see the large scale results of American Gut to see if there are people with results like yours and what their diet is.

I'd also like to see more researchers looking into RS in the context of traditional diets rather than synthetic RSs. It's always been interesting to me how many cultures have starchy gluey foods. For some reason I developed a craving for these a few years ago. I think it was when I lived in Sunnyside and I was eating a lot of pounded rice dishes, plantains, and pounded buckwheat etc.... and my stomach health was better than ever. The only one of those dishes on the RS chart I've seen, and one of the few actual dishes on the chart, is arepas. It seems to show some of them have a lot of RS.

The comments in my latest post have a short discussion on RS. The researchers who came up with the FODMAPs concept do seem to believe it would preserve healthy gut bacteria populations in people who otherwise have to restrict fermentable fibers

http://huntgatherlove.com/content/gluten-sensitivity-really-type-carbohydrate-intolerance#comment-1145579424

Not that supplementation is bad per se, I'm just a little hesitant for myself given past experiences with fiber supplements, inulin, etc.

Tim Steele said...

Melissa - Just read the comments on RS at your latest blog, it also reminded me why you are not an FTA fan...Richard was the only person who took me at face value last year when I was crusading for more RS, so we struck up a good relationship. I know he's not everyone's cup of tea, but all the RS has made him a nicer person!

As to potato starch being an unnatural fiber supplement, I struggled with that, too, as is Grace, still, I believe.

The reasons I have no problem with raw potato starch are:

- The amounts we are using, up to 4TBS, is the amount that could fairly easily be extracted from 1 large potato or a plantain. You can actually do this at home, it's not hard--just time consuming. (Look on youtube)

- Potato Starch extraction (in commercial operations) is a simple process: Steam blast peels off, grind cleaned potatoes into water, seive through smaller and smaller mesh filters until all that is left is starch granules, then dry the starch and package it. No chemicals used, so much water used that impurities are washed away.

- Ancestrally, we ate lots more prebiotic fiber than we eat today, much of it from raw tubers and roots (RS2). No way we evolved our magnificent gut on only RS3.

- It's either potato starch or raw potatoes--take your pick! Although dried plantains are a pretty good source of RS2 and easy to eat. 1 large green plantain contains roughly 40g of RS. Many also using plantain flour instead of potato starch.

Just FYI, here is a technical data sheet on potato starch from a manufacturer:

From a potato starch technical data sheet:
- appearance white powder
- moisture 20% max
- whiteness 95.0 min
- ph(30%suspension) 6.5-8.5
- ash 0.25% max
- sulphur dioxidc(so) 2ppm
- max viscosity peak 1790b. u
- granule size 150um(100 mesh sieve) 99.6% min
- packing: in 25kg white kraft paper bag.

Thanks for your interest!
Tim

Tim Steele said...

Melissa - If you wanted to explore RS and prebiotics in natural foods only, that would be awesome.

I think the biggest bang for the buck in terms of RS and edibility will be dried plantains (RS2) and fermented (soaked) beans (RS3). Other than raw potato, there's not much out there that people can eat raw for such a big blast of RS2.

RS3 is easy to get from real food up to about 20g per day. Look into converted rice...it's parboiled at the paddy and has phenomenal RS3, look at a GI chart--GI of parboiled rice is 30 or so, compared to 100+ for some other rice types.

You asked about reheating...

Reheating does not destroy RS3, it actually increases it. With potatoes and rice, a series of about 4 heating/cooling/reheating steps will maximize the RS, but the biggest increase is in the first heating/cooling cycle.

With rice, the best way to increase RS is to cook, freeze, then reheat by stir frying quickly in a hot oil. This will raise the RS from about 3g in 1 cup of warm rice to 15g in one cup of stir fried reheated rice.

Here is study looking at rice RS: http://onlinelibrary.wiley.com/doi/10.1111/1750-3841.12165/abstract

Dr. B G said...

Melissa,

Because I work out, have excellent insulin sensitivity (again) and for adrenal health, I returned to eating a lot of high GI starches (again) but expanded to the Asian pantry including whole grain brown rice, sorghum, adlay, buckwheat and red/black rices, in addition to the higher-RS purple tubers, white mountain yams and taro.

Here I am in Asia and millions of 70-80-90s year olds can't be wrong. The Okinawan diet is also low in rice, but high in sweet potatoes, purple Okinawan potatoes and yams. My genotyping is perhaps more agrarian as well -- Apo E2/E3 and FUT2 (-/-) non-secretor status. Also I feel best and optimal on this and the gut health reflected it as well.

You said the below which really struck me "I'd also like to see more researchers looking into RS in the context of traditional diets rather than synthetic RSs. It's always been interesting to me how many cultures have starchy gluey foods. For some reason I developed a craving for these a few years ago. I think it was when I lived in Sunnyside and I was eating a lot of pounded rice dishes, plantains, and pounded buckwheat etc.... and my stomach health was better than ever. The only one of those dishes on the RS chart I've seen, and one of the few actual dishes on the chart, is arepas. It seems to show some of them have a lot of RS."

How is pounded starches better for our guts, I wonder? Do you think the RS is retrograded? More digestible for the flora or for us?

'GLUEY FOODS'... Polymer starches -- this is RESISTANT STARCH. I studied food science at UC Berkeley so when I read the RS studies, it's like heaven. Do you know that most of the foods that are high in RS have much higher protein and much higher viscosity? The combination of amylose + protein lends to the higher RS content.

I think evolution somewhere (C4 to C3 or vice versa??) protected the 'baby starches' by raising cold-buffering proteins and polymer carbohydrates. I'd love to hear your thoughts. These proteins are analagous to lectins in grains -- self/seed protective defense mechanism. RS is actually found in nuts too -- again cold storage buffering I think.

For amylose to retain the biochemical energy, the plant intercalates the amylose strands into double stranded helical structures (like DNA) and upon cooking, gelation and retrogradation there can be higher RS content as the amylose further arrange into these strands or sheets of double helical structures.

It's interesting to me that the microbes which feed on RS prefer these double helical structures. The energy extraction is exothermic. This is partly why there is such a release of heat that is felt -- I get it about 3-5 hours after ingestion if I bolus 2-4 Tbs. (I wondered about this with one experimented I bolused 4-5 Tbs)

As a geek mom, I threw these princess parties for my daughters when they were 3-6 years old. We did a game where we made colored slime with borax and guar gum. This is a totally exothermic reaction, heat comes off the guar gum forming polymers on reaction with boric acid (detergent). Have you done this fun experiment?
http://www.flinnsci.com/Documents/demoPDFs/Chemistry/CF0377.10.pdf

Anyway, Asian starches are super mucusy and 'GLUEY' and of course naturally high in RS
--white mountain yams (can be eaten raw)
--cellophane mungbean noodles
--shirataki noodles (from konjac)
--mochi (as you mentioned; cold rice)
--soaked buckwheat porridge
--etc

OK to go into some anthro, I suspect that Asian culture developed this rich diversity of RS enriched foods faster and further than other cultures (let's say northern Vikings) because we had IRON. Thru cooking on iron woks, we no longer had to rely on iron from hunter-gatherer meat supplies. IQ and intelligence was retained.... or in fact excelled beyond typical hunter gatherer subsistence foraging/meat/scavenging, which lead to the a flourishing of culture, art and FARMING OF DIVERSE GRAINS, TUBERS AND LEGUMES.

grace

Dr. B G said...

Melissa,

Hope I'm not spamming your brilliant brain LOL.

Another thought that you've provided to me over the years since we met at AHS is the fact that we have eaten gluten for millenia and obviously some can handle better than others. Suddenly now post-neolithic, post-industrial age, the great majority of people cannot appear to tolerate (like Tim; I can tolerate -- now).

One of my favorite SIBO articles (Dukowicz Lacy Levine, 2007) have cleared up a lot for me, besides my own personal n=1 and my kids n=2. Now we eat gluten on rare occasion WITHOUT ANY (!!) of the problems that we used (my kids-- tantrums, mild hyperactivity, ADHD, oppositional defiance). So why?

These authors say 'Gram-negative coliforms, such as Klebsiella species, may produce toxins that damage the mucosa, interfering with absorptive function and causing secretion, thereby mimicking tropical sprue'

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099351/pdf/GH-03-112.pdf

Your recent blog is curious because I think you wonder the same things as I do.

I was once perfectly healthy after losing 30-40 lbs and eating croissants and sprouted Ezekiel everyday with peanut butter. WTF. How can things change to gluten sensitivity? For me it was horrific levonorgestrel toxicity, mercury, a tetanus vaccine, stress and a titanium dental implant. Long journey but now health is almost back to baseline (eating gluten with impugnity).

I think that we will learn far more as people receive input and feedback (useful and practical) regarding their gut microbiota, damaged small intestines, damage from pharmaceuticals and GMO crops, parasites, pathogenic overgrowths (like Klebsiella and candida), protozoa, worms, etc.

g

Dr. B G said...

http://huntgatherlove.com/content/gluten-sensitivity-really-type-carbohydrate-intolerance

I concur that both Perlmutter and Wm Davis are barking up the wrong tree!

For heart disease (and neurological and dementia diseases), in modern times there are other factors that create insulin resistance, SIBO and inflammation.

The TACT trial showed a tremendous and statistically significant 39% reduction in all primary endpoints (all cause mortality, heart attacks, strokes, etc) with EDTA, heavy metal chelation therapy (p=.002). In non-diabetics, the results were still striking 18% reduction in primary endpoints (p=.076).
http://www.mayoclinic.org/medicalprofs/trial-to-assess-chelation-therapy-cvuv10n4.html

Mercury inactivates DPP-IV, one of the gluten digesting enzymes, which is found in the tip of the microvilli. Undigested gliadin will trigger a cascade of small intestinal damage, opening zonulin, intestinal permeability, overgrowth of pathogenic bacterial and fungi, translocation of bacteria and fungi, and digestive issues. It is not GLUTEN PER SE but the damaged gut environment and increased opportunities for gliadin binding and entry. Certain gliadins are higher in transgenic wheat as well (~500X for one particularly toxic gliadin).

Mercury does other things too -- decreases thyroid enzyme function, lower body temps, neurotoxic like lead, xeno-estrogen effects, etc.

Excellent post Melissa as usual!

Melissa Mcewen said...

Thanks guys! A lot of great/interesting food for thought here.

Last night I was thinking about how some have posited that benefits from supplements are often actually benefits from the gelatin in the capsule. A lot of vegetarian capsules are made of potato starch, wonder if that can function as RS.

In addition I was thinking of "pica" in poor women, particularly in the South, which often manifests as eating plain starch like corn starch. It wouldn't be the first time "pica" has been re-examined. For example, clay and soil eating in many cultures has been found to actually have some health benefits.

Tim here is another blog post from a butyrate skeptic
http://www.ketotic.org/2013/11/similarities-between-germ-free-mice-and.html

I do wonder if some people just have a congenitally hostile mixture of native gut bacteria as a result of things like c-sections, formula, antibiotics, envi toxins like grace mentions that prevents them from benefitting from RS and other similar interventions. It's possible some other interventions might clear it up, but some of these species may be quite stubborn.

Tim Steele said...

Melissa - I read the ketotic.org blog yesterday and left a comment, I think we are all cool. I will admit I can't say how RS applies to a ketogenic dieter, but I have a hard time believing a long-term keto diet is healthful for most. I tried it and didn't like it.

"Pica"

http://en.wikipedia.org/wiki/Pica_%28disorder%29

I have never heard of that before...but I agree that eating things like chalk or cornstarch may be the body screaming to get prebiotics.

When I was in the Air Force, I spent a lot of time in the Middle East and had to take ciprofloxacin for 5 months in 2003. When I came home, I chewed ice for months--I couldn't get enough, even cracked two teeth doing it! It drove my wife nuts--I'd go through a Gatorade bottle filled with ice chips every evening and chew a SuperSized Wendy's cup full of ice at lunch.

I don't remember how long that lasted or why I quit doing it--but if you know anything about cipro, it makes a lot of sense now!


I'm not deluded enough to think RS and Potato Starch is a cure-all or magic bullet for people with parasites or serious gut dysbiosis, but I do think that RS is the 'missing element' in our diets.

I think we need RS just as much as we need a good Vit D level--through sun or supplements nobody has qualms about supplementing Vit D, and Vit D is intimately tied to gut health.

Grace has a great study that showed an increase in bifidobacteria can increase circulating Vit D OH 25!

Thanks for the discussion--I can't believe how much more I learn every day!

Dr. B G said...

Melissa

Thanks for your comments!

Tim has wonderful ideas, no?

Yes I think the recalcitrant species may also include fungi. As we add environmental toxins which lower our immunity and the burden from antibiotics which decimate the SFB and other commensals, we are left with proliferating and SUPER STUBBORN species like fungi and candida.

What I love about ancestrally prepared fermented foods, dirty carrots and soil based organisms/probiotics is that they give us the tools and technology to thwart the modern ills created by unbalanced ecosystems and recalcitrant gut/sinus/vag/oral/brain species our drugs can't touch. Feed them right to maintain the ecosystem with RS rich food or even potato starch, one of the cheapest prebiotics for SBOs or their cross feeders.

Have you written much on the SBO strains in ancestral foods in northern Europe? I bet fermented fish is enriched in SBO strains. Asian fermented shrimp paste, natto, black soybeans, Fish sauces and traditional soy sauces all have b subtilis and b licheniformis. These as u know break down and digest gluten. They also do far more.

They secrete a horde of antimicrobials, antifungals and biofilm busters. Sinuses, guts, oral cavities, etc are full of benign fungi but these switch to toxic pathobionts when antibiotics are added to the mix because the commensals and SBO are what control the fungal populations and shielding biofilms. anyway this was my problem after mercury and metals. The SBOs were the only way to finally crowd and eliminate the symptoms. Hopefully they're switched back to benign forms!

http://www.ncbi.nlm.nih.gov/m/pubmed/15591252/
http://www.ncbi.nlm.nih.gov/m/pubmed/19763411/
http://www.ncbi.nlm.nih.gov/m/pubmed/20552348/

G

Anonymous said...

which is a good SBO made without milk?
Thank You.

Anonymous said...

I'm curious about the difference between psyllium husk and psyllium powder. According to Mark Sisson (http://www.marksdailyapple.com/is-it-primal-paleo-bread-braggs-liquid-aminos-psyllium-fiber-and-other-foods-scrutinized/#axzz2mWvGrG00), the husk in not fermentable and we need to buy psyllium seed powder to get the prebiotic benefit.

Is there a certain brand/type of psyllium that you recommend?

Rob

The Natural said...

Rob,
My logic for taking psyllium husk (I think Tim and Grace will agree) along with RS is to move the RS further down to the distal portions of the colon. The fermentation needs will be met by the RS but what we need is to make sure the fermentation happens all along the colon and not just at the top. It much more beneficial to produce butyrate at the distal potions of the colon.

If you are just taking fiber alone then I would tend to agree with Sisson that seed powder might be more beneficial than husk for its superior fermentation quality.

That is my reasoning behind using husk and not seed powder.

T-Nat

The Natural said...

Oh BTW, this is the brand of psyllium I use. Very nice product at a very reasonable price

http://www.vitacost.com/yerba-prima-psyllium-whole-husks


T-Nat

Dr. B G said...

Anon,

No lactose in the below which contain soil based organisms that i luv luv luv. I've used them all and they're wonderful:

http://www.iherb.com/O-Donnell-Formulas-Flora-Balance-Bacillus-Laterosporus-Bod-Strain-60-Capsules/6078

http://www.iherb.com/O-Donnell-Formulas-Flora-Balance-The-Ultimate-Acidophilus-Plus-Bacillus-Coagulans-60-Veggie-Caps/12285

http://primalblueprint.com/products/Primal-Flora.html




Thanks T-Nat!!


Rob -- Not sure where you got the idea that the psyllium husk is not fermentable? it is quite fermentable! Honestly I don't know the difference between seed powder v. husk alone. Let me get back to you. In the clinical studies, I believe that psyllium husks are used but I need to verify. It's so funny. PS = two things, psyllium and potato starch. LOL What a merging!!

This is why I fell in love with PS (both) haa aha.

Yes the gut has multiple tiers of co-feeders in the ecosystem. Different species produce amino acids (N-fixation), carbs (glycans, etc), trigger our own glycans (mucus: fucose, etc), and SCFA -- volatile fatty acids. They each feed on each others by-products (e.g. poop and pee and sweat and secretions... YUMMM).

So annihilation of toxigenic fungi and pathogenic microbial overgrowth of the small intestines and large intestines requires optimal feeding of the good beasts -- RS + NSP is the optimal combo in one study. Both are better than each singly alone for colon outcomes. Perhaps this is because synergistically it feeds the ecosystem and they have different roles. RS granules are quite 'tight' and dense biochemically. This is why our amylase enzymes cannot degrade them ('resistant').

The microbes adhere and attach until reaching more suitable and prime environments (less acidic, less bile) in the large intestines but along the way they travel and other microbes attach (like SIBO ones).

RS is shaped in DNA double helical fashion. The energy in the carb bonds is highly dense and sophisticated in organization -- in fact quantum structured. This is evolved and not just chance and microbial randomness!

Our DNA is so efficiently organized for data, did you know?

DNA as classical and quantum information system- Implication to gene expression in normal and cancer cells

http://www.doiserbia.nb.rs/img/doi/0354-7310/2005/0354-73100504115K.pdf

g

Dr. B G said...

Basic element in our consideration is hydrogen bond, which possess both classical and quantum properties.
Based on new vision of old data we develop synergetic (classical/quantum) model of DNA information
processing, which may help for better understanding the functions of "junk" sequence in genetic code.
We believe that "junk" sequences may be active regulatory factor of system complexity trough microtubules (centrioles) and water in living systems

(hat tip: todd for quantum)

Anonymous said...

Thanks DR. for the two O'Donnell Formulas. should i take both together? Thank You

David V said...

I have minor nightshade sensitivity. Would you consider Potato Starch a no-go for me - or is it okay since it's refined? Or can you suggest an alternative?

Tim Steele said...

David - I haven't seen any signs that people with nightshade allergies are allergic to potato starch, BUT, if I had bad reactions to nightshades in the past, you'd probably not convince me to try potato starch.

There are alternatives. Plantain flour, aka green banana flour, is about 50% RS by weight and easily obtainable. If you can't find it--you can make dried plantains easily at home.

Other options are mung bean starch (not sure how easy it is to get) and sorghum flour.

Tapioca starch/flour is said to be a good source, but in reality may not be. Tapioca comes from cassava, which is full of cyanide when raw. It has to be treated to remove the cyanide and I think this may destroy most of the RS.

A food-based approach can also be used, but takes some doing and planning. Eat lots of rice, potatoes, and beans that have been cooked and cooled (reheating OK), and learn to love bananas that are still very green. Also look into the tubers and roots Grace talks about in the blog. Check out Shiritake noodles, too.

Potato starch isn't the be-all end-all I make it out to be, it's just an easy solution in our fast-paced world.

Unknown said...

Really can't thank Dr. BG, Tim, Keith and everybody who comments here enough! I'm seeing my primary care doc next week and am wondering if I should ask her to order the GI Effects Comprehensive Profile and possibly the MEGA sporebiotic.

Here is my situation in a nutshell:

49-year-old male, generally healthy and fit, have followed one version or another of paleo eating since reading Ray Audette's Neanderthin way back in 94. I've never had gastrointestinal problems.

Last August, a few weeks after swimming in a lake, I started developing discomfort in my lower left abdomen. Eventually ended up seeing a gastroenterologist who was certain I had diverticulitis. He prescribed a round of Cipro and Flagyl and scheduled me for a CAT scan. Even though the radiologist's report indicated nothing other than some possible thickening of the distal colon (more likely due to the colon being empty and "folding" somewhat), the doc said I had diverticulosis and he wanted to do a colonoscopy.

After seeing my primary care doc, I declined the colonoscopy and she ordered the Genova Diagnostics Comprehensive Digestive Stool Analysis (I'm happy to share those results if anybody wants 'em!). No parasites were found. My doctor put me on nystatin and encouraged me to try various natural approaches.

I've tried all manner of different probiotics, none of which seem to make much difference. After reading these posts on curing SIBO, I started taking 1 Garden of Life Primal Defense Ultra, 1 Natren Healthy Trinity, 2 tablespoons unmodified potato starch, 1 tablespoon psyllium husk, 5 Amazing Greens capsules, 1 heaping teaspoon of glutamine, 2 tablespoons diatomaceous earth, and several drops of oregano oil. I take all this twice daily. Unfortunately, this regimen doesn't seem to be helping.

I've ordered Prescript-Assist and should receive it today. I'm going to use it instead of the Primal Defense.

Anyway, I never thought about the lake connection until recently and I'm wondering if the GI Effects might identify something amiss in my guts that the Comprehensive Digestive Stool Analysis did not. And I'm wondering if the MEGA sporebiotic might be a good idea for me. I should mention that the pain varies in intensity and location. This, along with my CAT scan result, makes me think there's nothing physically wrong with my colon but definitely something wrong with my micro-biome.

So… thoughts?

Tim Steele said...

unknown - Maybe I'm missing it, but when was cipro and how long have you been doing potato starch and probiotics, etc..?

Cipro is like napalm to gut bugs--seriously bad stuff.

I'd give what you are doing 3-6 weeks. If still bad after that, don't know. They tested for Giardia? But if you had that, you'd really know it.

What exactly are your symptoms right now compared to say a year ago?

So do you have diverticulosis? Or do you not believe it?

Grace may have more....

Unknown said...

Hi Tim,

I should have signed off my post as Mike (same Mike asking earlier about the safety of SBO's). Here's a little more precise chronology of my symptoms and treatments:

6/28/2013 swam in the lake
July 2013 onset of symptoms (can't say exactly when)
8/13/2013 start Cipro and Flagyl (I think it was a 10 day course)
September-November 2013 I experimented with various elimination diets: GAPS, FODMAPs, SCD, low histamine, low oxalate. At one point for about a week I ate nothing but homemade chicken soup with no vegetables.
2013/11/23 Started the regimen described in my previous post with everything except the SBO's. This is when I reincorporated unmodified potato starch into my diet. I have been experimenting with it off and on for the past few months since reading about it at Free the Animal.
2013/11/29 started taking Garden of Life Primal Defense Ultra SBO's
2013/12/7 assuming delivery today (we've had an ice storm here in Texas) I'll start taking the Prescript-Assist

So, I've been back on resistant starch for 2 weeks, SBO's for one.

The gastroenterologist drew blood to check for infections, so I'm assuming Giardia was checked. My symptoms have stayed about the same, but they do "move around" sometimes. When I 1st started experiencing this, it was in my lower left abdomen. Nowadays, I notice it often higher up, more diffuse, but still on the left side, basically tracing the vertical left portion of my colon. On rare occasions, I get discomfort on the right side.

Sad to say, but I don't trust my gastroenterologist. He said I have diverticulosis, but that was not on the radiologist's report that accompanied my CAT scan. So, I may or may not have diverticulosis. The fact that diverticulitis has been ruled out though indicates that whether or not I have diverticulosis (which has no symptoms), my symptoms are due to something else.

Mike

Tim Steele said...

Mike - It's hard to say what's going on, but you have only just begun a smart approach. The cipro may have killed a lot of good gut bugs and left some bad ones. You may have some freak parasite, who knows?

If it were me, I'd give it a month if you aren't in too much agony. Otherwise you are at the mercy of your doc.

I took cipro during the Gulf War and it totally wrecked me and thousands of other GI's. Stomach cramps, heartburn, nerve damage, and other weirdness. Cipro is bad stuff!

This is very recent warning on cipro: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm126085.htm

Tim Steele said...

Sorry, this is latest warning--that was from 2008! This is from 2013:

http://www.fda.gov/Drugs/DrugSafety/ucm365050.htm

And this is my new world: http://www.airforcetimes.com/article/20131101/NEWS/311010018/New-FDA-warnings-Cipro-may-tie-into-Gulf-War-illness

Dr. B G said...

Anon,

The Ultimate Lactobacillus of course can be (should be?) combined with Flora Balance/Bacillus Laterosporus.



David V,

I'm not certain if one individual at Free the Animal had an 'allergic' reaction out of the perhaps vocal n=100 that have reported results. Spanish Caravan reported that after 3-4 wks on the potato starch, he had a reaction similar to his nightshade allergy. He then used potato starch in an enema and repeated 2-3 times, I believe, with absolutely fantastic results (super improved sleep, dreams, mood). On the 3-4wks of PS as an oral prebiotic, the results he reported included going from 'limp' to 'MOBY DICK'.

What reaction do you have with nightshades (peppers, chili, tomatoes, potatoes, eggplant)? Has this improved or gotten worse with Paleo?

g

Dr. B G said...

Mike,

I hate the CDSA.

Did you read my blast on it compared with the GI Fx stool DNA PCR test?
http://drbganimalpharm.blogspot.com/2013/09/my-n1-pre-and-post-microbiome-digestion.html

Dr. B G said...

Mike,

Parasites have a cell cycle -- they and the cyst forms are not ALL 100% killed off immediately... If you have one parasite, nowadays it's not uncommon to have more than one (like me -- bacterial + parasite overgrowht). My kids on the hand had only one parasite or overgrowth.

Here is some background info that I think you might enjoy. Cipro is never used for giardia so really if giardia is in the differential diagnosis, it would stay in the differential. (Though Cipro appears to have petri dish activity). With Flagyl (metronidazole), It will kill in the first round, but again the 'protected' parasite life forms (cysts) would prevail and re-infect later. There is apparently a 90% relapse rate commonly reported with metronidazole for Giardia.

Read this first -- it's the integrative medicine approach to SIBO and parasitic/pathogenic overgrowths.
Hawrelak. Altern Med Rev 2003;8(2):129-142.
http://www.thorne.com/altmedrev/.fulltext/8/2/129.pdf


Other background incl conventional (again they don't work completely often because imho fail to understand the gut ecosystem)
http://www.nytimes.com/health/guides/disease/giardiasis/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2726062/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC88965/

Dr. B G said...

Mike~

Thanks for providing more clarification. Wow you've been thru a lot of DIY healthcare. Good thing we have the internet, eh?

The good news is that all the 'treatment failures' for antibiotics, PS, SBO probiotics and dietary changes tell a storyboard suggesting other root causes. You've done it all -- seeding and feeding.

What about WEEDING?

Let me list a couple of my thoughts
--- no GI symptoms then you swam in a large body of water then immediately afterwards developed L-sided discomfort. BTW way I love Ray Audette. ;)

You've tried everything including two very potent, broadspectrum antibiotics -- cipro and metronidazole, and symptoms failed to change/improve. Nothing else you've tried has made a dent.

I think your conclusions are probably correct -- the antecedent event was the swimming and I presume accidentally drinking of lake water which probably contains parasites, protozoa, or possibly giardia.

Nothing has been correctly clinically diagnosed but it sounds like the CDSA found only yeast/candida overgrowth hence the Nystatin. Surprising because on the CDSA often yeasts/fungi don't grow out (yet ANOTHER REASON WHY I HATE THIS TEST BEC IT DOESN'T DX FUNGI).

This is precisely why I abhor the CDSA because it leads docs down the wrong path, missing the primary infectious disease diagnosis.... 80% to even 95% of stool parasites, yeasts and overgrowths cannot be cultured by humans with our current technology. When things go wrong in the gut in autoimmune or chronic diseases (HTN, T2DM, Heart disease), it is actually subclinical microbial/parasitic overgrowths.

Naturally after one round of TWO POTENT SYNTHETIC antibiotics, pathogenic fungi will be selected and overgrow. All the natural defenses and protective commensal bacteria/fungi will be gone or even extinct. Whatever pathogenic growths/parasites you had earlier will grow even stronger and grab a deeper foothold into the gut architecture.

The botanical and drug you were on -- oregano and nystatin -- do not touch protozoa or parasites strongly enough. Nystatin is narrow and only fungicidal. Oregano is good but not adequate alone for killing.

I can see a few solutions that you and your obviously integrative doc must consider together:
1. Consider the value of getting the right tests -- GI FX 2200 and ONE. If not contact me or other functional medicine practitioner. Don't do the O&Px3 -- this can miss many things as well.
2. Consider the value of getting the right diagnosis or treat empirically
3. Consider the value of treating the correct diagnosis and rebuilding the gut architecture


Cipro+ Flagyl are not just napalm. It's like an atomic bomb...

g

Anonymous said...

Hi Tim

You wrote " This is what I think is the best possible use of the ingredients:

1-2TBS potato starch, 1 TBS psyllium husk, 1-2TBS of the green powder.......
Drink this concoction 1-3 times a day, ..... Increase the amounts of potato starch, but never to more than 4TBS at once."

Do you mean to say you could take 12 TBS of PS per day?

Tim Steele said...

You could, but I wouldn't.

If I was going to do multiple drinks like that, and I do sometimes, I'll use 1-2TBS of potato starch. If I just do one drink per day, i use 2-4TBS.

12TBS a day would be overkill I think, but not harmful. I think you would just pass most of it without fermenting it at all, but you could certainly ferment 1-2TBS at a time if taken several hours apart.

Hope that clears it up!

Anonymous said...

Grace/Tim, how long do you think we should be taking probiotics for? I started SBOs (Probiotics 3) and Primal Defense 3 weeks ago and recently also added Prescript Assist upon high recommendation from Chris Kresser. I'm taking 3 at the same time. Is that ok? All of them are about 30 pills so I'm about to run out. Do you think I should take all 3 simultaneously? I take 4 tbsp of PS with them dissolved in water.

I can already see improvement and I feel like my gut is being rehabbed. Lots of gas and turmoil when started but now very calm down there. How long is the probiotics regimen supposed to last. Or is it advisable to take one of the three (or all 3) indefinitely, as you would RS? Thanks. Namby

Dr. B G said...

Namby,

So glad to hear you are feeling subjectively better! Probiotics are like fermented foods -- I believe the dose is individual and kinda depends on the person and their current gut status.

If you look at the Burkino Faso kids who eat a fiber/cellulose + termite rich diet, they consume seriously spectacular quantities of prebiotics and probiotics. The termite (eaten crunchy raw, i believe) have gut flora and microbes in their bellies. Even if I switched over to their diet, there would probably quick adaptation but likely a period of shifting gut colonies and subpopulation movement.

http://neuroanthropology.net/2010/08/04/whats-in-your-gut-termites-for-example/
http://www.ecologyandsociety.org/vol14/iss1/art48/

Tim Steele said...

Namby - What my wife does with SBO (probiotic-3) is take them just a few times a week, one pill only along with a potato starch infused snack or drink.

The directions on the bottle say 'take 3 pills a day' I believe--who does that benefit? The manufacturer! I'm surprised they don't say to take 10 pills a day.

If your gut is ready to accept them, you should only need a couple of the bacteria. It will attach and grow like nature intended. If your gut isn't ready, all the Pro-3 in the world will do no good.

I'd say, make that 30 day supply last about 6 months.

If you read up on probiotics, prevailing wisdom is that the best you can hope for is transient populations drifting through as you pop probiotic supplements. With a good RS program from real food and/or supplemental raw starch, everything gets turned upside down with respect to having a modern gut--you will eventually get a gut like nature intended--one that controls inflammation and produces neurotransmitters, creates vitamins, absorbs minerals, and detoxes heavy metals and contaminates.

A big confounder in all this is damage done to vili and musculature (peristalsis, sphincters, and brakes) in the gut. But, keep on top of diet to make a good environment and you remove one HUGE piece of what holds most people back from good gut health.

Anonymous said...

Thanks Dr. BG and Tim. Yes, I was getting the feeling 3 times a day is a bit too much. The same with Primal Defense and Prescript Assist, I would think, right? I was getting weird looks from colleagues at work who saw me mix Primal Defense and RS in Almon drink.

My fingernails are clear and my cold fingers are gone. Oh, I didn't want to tell you this just yet. But my Sjogren's antibody (SSB-LA) turned negative last week! That's after being on the RS/Probiotics regimen for only 3 weeks! I was on RS since August, however. Also, one of the incipient lupus antibody that I tested positive (Chromatin) turned negative this time! My ANA is positive but with very low titer (1:40). That's the lowest I ever tested and even normal people test at that level. My rheumatologist will be confused!

If this holds up, and I'm hoping it does, I have cured an autoimmune disease. No symptoms and no antibody: that's a 100% cure. Not just remission. Being antibody-negative is not supposed to be possible, right? Whither molecular mimicry and eternal damnation, I mean, eternal autoimmune tissue attack? You mean, that's contolled by the microbiome, too? So much for Dr. Fassano and leaky gut(which I now realize seem to have been a foil ... it happens but the underlying condition seems to be gut dysbiosis and bacteria).

Wow, I gotta try this on my aunt who also has Sjogren's and my cousin who has Lupus. Thanks so much guys. This is not what modern medicine says is possible!

Unknown said...

This is Mike again.

Hi Dr. BG, Tim, and everybody else. I have news and data! The news is that even though my doctor was not particularly thrilled about having me do the GI FX 2200 (her complaint was that when she had prescribed it and it came back positive for parasites, often the parasites were not identified), she did prescribe it along with ONE. I've sent off the GI FX 2200 sample and am waiting for her office to get in a ONE kit.

The data is my American Gut Project results. Got it back and it's from 8/8, more than a month after my suspected infection date. Here's the data:

From the bar graph:
Firmicutes appear to be about 78%
Bacteroides 16.2%
Proteobacteria appear to be about 1-2%
And everything else registers less than 1%

My most abundant microbes:
Genus Ruminococcus 28.2%
Family Lachnospiraceae 18.5%
Genus Bacteroides 16.2%
Genus Ruminococcus 10.0%

My most enriched microbes:
Taxonomy, Sample, Population, Fold
Order YS2, 0.9%, 0.05%, 19x
Family Lachnospiraceae, 18.5%, 7.42%, 2x
Genus Dorea, 2.4%, 0.62%, 4x
Genus Ruminococcus, 28.2%, 2.39%, 12x

And my report says there were no rare or unique taxa in my sample.

In other news, I switched from Garden of Life Primal Defense probiotic to Prescript-Assist on 12/9. Not really noticing any difference in symptoms. Sometimes it's better sometimes worse.

Think y'all so much for sharing your insights!

Dr. B G said...

Dear Anon,

CONGRATULATIONS~!!!

I love your story! If you have time, please email me off line later. There are some details that I'd love to confirm.

Personally I believe the dose that you took (high dose probiotics) benefitted the autoimmune condition. If you do not consume dirt (organic, composted, no parasites) on a REGULAR AND ROUTINE SCHEDULE, then I believe the SBO probiotics -- Prescript Assist, Probiotic-3, Primal Defense, etc -- have more sustaining disease-modifying spectrum than random 3x/week dosing. Does that make sense? You can FEEED FEED FEED the microbiota all you want, but if the keystone soil based organisms which our ancestors from 4 BILLION YEARS AGO co-evolved with are completely extinct, then WE need to supply them.

Seeding the gut with the appropriate synbionts provide the host:
--tighter junctions in all mucusal surfaces including those tear and salivary glands in Sjogren's
--SBOs combat pathogenic microbes by secreting chemicals that don't hurt the commensals (or themselves): ANTIFUNGALS, ANTIBACTERIALS, ANTIPARASITIC
--SBOs make vitamins that a broken gut doesnt absorb or make (B complex, B12, K2)
--SBOs and synbionts assist in mineral absorption instead of hijacking Mag, Zinc and other nutrients that pathogenic yeasts and bacterial steal from us for their survival



I love LOVE LOVVVVVVVVE what you said here! "My fingernails are clear and my cold fingers are gone. Oh, I didn't want to tell you this just yet. But my Sjogren's antibody (SSB-LA) turned negative last week! That's after being on the RS/Probiotics regimen for only 3 weeks! I was on RS since August, however. Also, one of the incipient lupus antibody that I tested positive (Chromatin) turned negative this time! My ANA is positive but with very low titer (1:40). That's the lowest I ever tested and even normal people test at that level. My rheumatologist will be confused!"

Honey you made my WEEK!!!

Dr. B G said...

Anon, Please contact me -- click 'Email' on left-side
http://www.blogger.com/profile/15451872961651116061

Dr. B G said...

Mike,

I'm encouraged by journey -- please keep me posted. I was talking to Kor who had a (+) (unknown) parasite result with the GDX GI FX stool test.

http://drbganimalpharm.blogspot.jp/2013/09/my-n1-pre-and-post-microbiome-digestion.html?showComment=1387269593372#c2095655726666817531

Did you read the Giardia article?

I'll post what is relevant to us humans who have parasites, worms, protozoa and pathogenic overgrowths which is EPIDEMIC because we fail to sustain the growth of soil based organisms in our gut with regular maintenance, exposure and gardening/touching dirt kind of inoculations...

Your AmGut is vastly different from Tim, who gardens with his bare hands, hunts ducks and handles them with bare hands, and maintains free range chickens and eggs year round in Alaska. He eats directly from the non-pesticide organic, composted SOIL. The eggs and chickens spread Bacillus licheniformis (my favorite SBO probiotic -- I [HEART] B licheniformis).... beat that Mike! They POOP AND CRAP all over his amazing garden!

Free SBO probiotics on his raw veggies! lol

AmGut gets the Archae and bacteria but misses a ton of info about our gut ecosystems
--yeasts, fungi
--parasites
--worms, hookworms, pinworms, helminths
--protozoa


You know we can all be exposed and succumb to protozoa like giardia without swimming in large bodies of water. There is backflow from municipal sanitation facilities that use protozoa to breakdown sludge...(protozoa EAT bacteria because it's a dog-eat-dog ecosystem) NICE, eh? (Hat tip: KEITH BELL thx dude)

http://www.statesman.com/news/local/study-finds-lightly-regulated-wastewater-plants-polluting-edwards-1986868.html

http://www.sciencedaily.com/releases/2011/01/110119162509.htm



From the Giardia article: The below explains the pathophysiology between ALL SIBO and SIFO -- how the microcritters that turn aggressive (aka pathobiont) invade and deliberately suck the life out of us.

Pathophysiology

Once excystation occurs, Giardia trophozoites
use their flagella to “swim” to the microvillus-
covered surface of the duodenum and jejunum,
where they attach to enterocytes using a special
disk located on their ventral surface.13 In addition,
lectins on the surface of Giardia bind to sugars on
the surface of enterocytes.14 The attachment process
damages microvilli, which interferes with
nutrient absorption. Rapid multiplication of trophozoites
eventually creates a physical barrier
between the enterocytes and the intestinal lumen,
further interfering with nutrient absorption.13 This
process leads to enterocyte damage, villus atrophy,
crypt hyperplasia,15 intestinal
hyperpermeability,16,17 and brush border damage
that causes a reduction in disaccharidase enzyme
secretion.18 Recent research also demonstrates the
presence of cytopathic substances, such as glycoproteins,
19 proteinases,20 and lectins12 that may
cause direct damage to the intestinal mucosa. Trophozoites
do not usually penetrate the epithelium,
invade surrounding tissues, or enter the bloodstream.
Thus, infection is generally contained
within the intestinal lumen.13

Giardia trophozoites scavenge nutrients in
the intestinal lumen for sustenance and growth.
Glucose appears to be the primary energy source,
with other sugars appearing not to be utilized. The
amino acids alanine, arginine, and aspartate are
readily used by Giardia trophozoites for energy
production. It appears Giardia lacks the ability to
synthesize most amino acids and is thus dependent
on scavenging them from the intestinal milieu.
7
Animal models suggest Giardia is unable
to survive in the small bowel in the absence of
bile acids. Uptake of bile acids by Giardia may
explain the fat malabsorption often seen in giardiasis
patients.6 Chronic giardiasis also results in
malabsorption of lactose, vitamin B12, and fatsoluble
vitamins, which can result in weight loss,
nutritional deficiencies, and failure to thrive in
children.12 Exposure to bile is the primary stimulus
for encystation, where trophozoites transform
into cysts that pass out with the feces.7

Unknown said...

Dr. BG, this is Mike again. Yes, I did read the Giardia article, thank you. I'm not sure that's the critter that's bothering me because I never really had terrible diarrhea.

I went ahead and ordered the Thorne Berberine you recommended. I'm wondering if there's anything else I can/should do while waiting for my GI FX 2200 and ONE results. I was thinking of taking Bacillus licheniformis, but it looks like the only source is MEGA sporebiotic.

Dr. B G said...

Hey Mike,

No I was giving an example of protozoal attachment and gut disrupting damage for the digestion, peristalsis, bile, acid, and valves. Overgrowths in the small intestine are multilayers of GI fucked-up.

Besides licking my ass or the ass of Tim "Tatertot" Steele's, you may consider purchase of B licheniformis from Body Biotic!

JUST KIDDING.

Unknown said...

Thanks for your recommendations, Dr. BG! I think I'll start off with with your less adventurous suggestion and order some Body Biotic!

Dr. B G said...

I'm a smartass and gosh so glad youre a smart boy! LOL

Tim Steele said...

Mike - what was your diet like when you gave the sample? Were you getting any RS?

From what you see on your sample, it looks to me like you suffer a serious lack of diversity in your gut flora. You have the basics, but none of the probiotics. The Firmicutes and Bacteriodetes are like the mutts--good, bad, indifferent. Everybody, even someone who has just undergone antibiotic treatment, is going to have Firms and Bacts. These are the guys that degrade food and put out smelly gasses and do a so-so job of everything.

The dominance of Firmicutes over Bacteriodetes is linked with metabolic syndrome and obesity, but it's not 100% true.

The Lachnospiraceae and Ruminococcaceae are both Firmicutes and two of the most abundant families, and have been associated with the maintenance of gut health. While they are both diverse groups, they share a common role as active plant degraders.

Your YS2 probably refers to Thermodesulfobacterium, a Group II sulfate-reducing bacteria because it can can utilize acetate and other fatty acids, oxidizing them completely.

So, really, this Am Gut test shows you have Standard American Guts. I'd love to see you retest after Grace's plan for 4-6 months.

From the bar graph:
Firmicutes appear to be about 78%
Bacteroides 16.2%
Proteobacteria appear to be about 1-2%
And everything else registers less than 1%

My most abundant microbes:
Genus Ruminococcus 28.2%
Family Lachnospiraceae 18.5%
Genus Bacteroides 16.2%
Genus Ruminococcus 10.0%

My most enriched microbes:
Taxonomy, Sample, Population, Fold
Order YS2, 0.9%, 0.05%, 19x
Family Lachnospiraceae, 18.5%, 7.42%, 2x
Genus Dorea, 2.4%, 0.62%, 4x
Genus Ruminococcus, 28.2%, 2.39%, 12x

Unknown said...

Hi Tim,

This is Mike again. IIRC, my diet was low-carb paleo at the time of my sample. Lately I've been going more Perfect Health Diet, eating Japanese sweet potatoes, some white potatoes, and occasionally white rice with my usual paleo fare.

I just ordered the Body Biotic recommended by Dr. BG and will start it on Friday and I'm eagerly awaiting the results of my GI FX 2200.

Now I'm going to throw you all a loop. Shortly after my gut pain began, I started testosterone supplementation therapy, injecting 0.25 mL testosterone cypionate and 0.25 mL hCG twice-weekly. Prior to beginning, my cardiac CRP (not hsCRP) was 0.87 on a 0.00-3.00 scale. Just got it measured again and it came back at 6.75! I have never had high CRP, hs or otherwise.

My doctor left me a voicemail saying she thinks it may have something to do with the hCG, but I'm wondering if it has to do with my gut dysbiosis.

Bet y'all didn't see that one coming…

Frasier Linde said...

I'm also curious about psyllium husk vs. seed powders. There is some discussion on them here: http://www.healingwell.com/community/default.aspx?f=38&m=2152224

Keith Bell said...

Hey Mike, if you really believe you picked-up something in a lake, it could be any number of things including worms or spore-forming antibiotic resistant clostridium bacteria. Did you actually drink lake water?

As Dr. B G points out, you've done a lot of seeding and feeding and suggests more weeding. One broad spectrum natural antimicrobial is ionic colloidal silver and it's a pretty big gun to consider. It may be worth your researching to determine the best type and protocol. You can even make your own with a generator. I don't believe resistance is possible with silver. Anyway, my heart goes out to you and I hope you eliminate this problem sooner than later.

Unknown said...

Hi Keith,

I have no idea if I picked up something at the lake. I certainly didn't drink lake water! In fact, I don't think I even submerged my head. I will certainly look into colloidal silver, but before trying it (if I do), I'm going to wait until I get my GI FX 2200 results. Meanwhile, I'll be starting the berberine today and the Body Biotic probiotic tomorrow.

BTW, got a preferred link where I can start my colloidal silver research?

Keith Bell said...

OK, I understand the connection with the lake is speculation. Keep in mind you don't have to drink lake water to be infected an many things can penetrate skin including protozoans, helminths such as hookworms and flukes. Giardia is a protozoan and I'm not sure if it can penetrate skin; far from expert. Sorry, I don't have a suggestion regarding researching colloidal silver, though I do believe the ionic form is best. Hopefully, your lab tests will reveal cause.

Dr. B G said...

Frasier

Thanks! Probably both types are fine as long as one doesn't have allergic reactions.


Keith

Thanks for your thoughts. I haven't researched the technology behind silver nano particles.


Mike

What is a 'cardiac CRP'? This is usually hsCRP I thought. It is quite an unreliable inflammation marker. Any sniffle or sneeze can raise hsCRP.

Here's a decent silver ION review
(google AEM Jung Koo Park silver ion antibacterial )

Sorry cant paste on silly iPhone


Any antecedent event can cause pathogen and parasite infiltration if our defenses are susceptible or we are immunocompromised (immunosuppressive mercury, gut disrupting gluten, cortisol, drugs, etf) or they just simply happen. Parasite WINS. This is the reason for SEX AND REPRODUCTION. Our Red Queen creates genotype and polymorphisms to evade future and anticipated parasites and predators.

Anyway modern hominids have many sources modern parasites transfer.....
--food and contamination (happens ALL THE TIME)
--municipal or well water
--sex partners
--pet exposure (sorry. This includes little children too)

Frasier Linde said...

I've ordered the seed powder, as I don't seem to handle insoluble fiber well yet.
I also just noticed the following statement on the Body Biotics website, and was wondering your thoughts: "The use of psyllium seed husk with Body Biotics™ is discouraged because of its indiscriminate stripping away of both friendly and unfriendly bacteria. Use of psyllium seed husk could minimize the positive health benefits of Body Biotics™."

Keith Bell said...

MIke, another idea is OptiMSM in therapeutic dose a few times daily as it has lots of antiparasitic properties (including giardia and worms) and is totally non-toxic. OptiMSM is a pure form of MSM (sulfur) made via distillation. I like the Source Naturals brand at vitacost.com. If your problem is something other than a parasite such as fungi, it will help with that too as sulfur is fungicidal and it raises pH so fungi can't survive.

Unknown said...

Dr. BG

I asked my doctor specifically for hsCRP. She told me that the lab they use only does 'cardiac CRP,' whatever that is.

Keith

Thanks for the info on OptiMSM. I will definitely explore using it as soon as I get my GI FX 2200 results.

Meanwhile, I do have some good news. I've been taking the Thorne Berberine and the Body Biotics for 3 days now and my gut feels really good today. Too soon to say if things are truly getting better, but this sure beats the alternative!

Also, after reading Richard's post about the way probiotics make love to resistant starch, I started opening up the Body Biotics capsules and mixing the contents with my potato starch. In addition to this, after reading Dr. BG's colorful descriptions of Tim's life with the chickens and the dirt, I've also gone as far as rubbing some of the Body Biotics contents onto my hands and the skin on my legs and arms. Doing all I can to get the good critters on my insides and my outsides!

Pete said...

Hey Keith. What would you consider to be a therapeutic dose of MSM?

And how would you take that in the SIBO protocol? At least 2 hours away from RS+SBO's I'm assuming?

Thanks

Unknown said...

Well, that took forever and a day. Turns out my doctor's office has been sitting on my G.I. FX 2200 results instead of sending me a copy. Here's they are:

Bacteroides spp. 3.0
Clostridia spp. 2.5
Prevotella spp. 3.9
Fusobacteria spp. 3.0
Streptomyces spp. 4.5
Mycoplasma spp. 3.5
Lactobacillus spp. 3.9
Bifidobacter spp. 2.9
Escherichia coli (E. coli) 2.6

No clinically significant amounts of Opportunistic Bacteria.
No clinically significant amounts of Yeast/Fungi.

Cryptosporidium – negative
Giardia lamblia – negative
E histolytica/dispar – negative

Firmicutes 59%
Bacteroidetes 41%

Total SCFA – 111
n-Butyrate – 26.7
Acetate % – 63
n-Butyrate % – 24
Propionate% – 12
Valerate % – 1.0

Lactoferrin 1.6
Mucus – Negative

Fecal sIgA – 80
pH – 5.9
Color – Brown

Elastase 1 – 100
Triglycerides – 60
Putrefactive SCFA – 1.5
Vegetable Fibers – Rare

LCFAs – 7.5
Total Fat – 10.5
Cholesterol – 92

Thoughts?

TIA, MIke

peter said...

hi, has it to be raw potato starch or is any potato starch you can get in a regular supermarket fine?
regards peter

Tim Steele said...

Mike - I'm no expert, but I see no big red flags. If I were you, I'd just start eating lots of fermented foods, take a probiotic now and then, and work on getting lots of RS from real foods.

Peter - Any potato starch you can buy in the supermarket is fine. It will normally say 'unmodified' meaning it's not laundry starch.

By raw, we mean, don't use it in cooking. Put it straight into yogurt, milk, water, etc... drink cold.

Unknown said...

Hi Tim,

Thanks for looking at my data. I've been doing everything you suggest, but am still having gut issues.

A couple things did stand out for me from my G.I. affects 2200 report:

Among my beneficial short chain fatty acids, both propionate and Valerate were really low. Propionate was a 12 on a scale from 10-29 and valerate was a 1.0 on a scale of 0.4-4.6.

My pH was a 5.9 on a scale from 5.7-7.1.

Pancreatic elastase 1 was 100 and the report says that anything less than 100 is strongly associated with severe pancreatic insufficiency and that levels of 100-200 identify moderate pancreatic insufficiency.

If anybody else has any opinions on my lab work, I'd love to hear them.

Peter said...

Thanks for the answer. Is it possible to take the mix together with clay or bentonite? I am on a psyyllium bentonite mix to remove biofilm... So could I add in the PS or wouldnt this be a good idea?

peter said...

And why do you think that RS would only feed the good flora and not the sibo?
SCD says there is the need to avoid all disaccarides to heal sibo.
I read of some cases where probiotics as a therapy for sibo made them worse. so why do you think your approach is a better one than the scd? Thank you very much.

Ann said...

Tim, I'm confused about something. I posted my MM GI Effects results and told you that my PH was high at 7.0. Does that me I'm acid or akaline? My understanding is that I'm alkaline, and that I need to be more acidic for my gut bacteria. But as I'm shopping for the Amazing Grass, they state that the "Alkaline green plant foods balance acidic pH levels"

Is that going to change my levels for the better? It doesn't seem that way to me, but I don't know much about this, and it doesn't explain anything on my test. The test has an "H" for high, but my husband says neutral is 7.0. What should it be for optimal gut bacteria?

Tim Steele said...

Ann - yes, you are too Alkaline, even if your result is neutral, you want a fecal pH that is slightly acidic. This is accomplished by eating foods that result in microbial populations that produce short chain fatty acids--the foods themselves may be very alkaline.

The acidity is from butyrate, acetate, and propionate--acids formed by gut bugs.

Fecal pH should be in the 6-7 range. This is the range that probiotic bacteria LURRRRVE (as Grace would say). Too acidic is just as bad. There will be a sweet spot, mediated by flourishing good gut bugs.

I have no idea why your pH is what it is, I assume it's an imbalance of gut flora, but exactly how to correct it is the million dollar question. RS/Fiber/Probiotics/look for pathogens and overgrowths, yeasts, all that.

Here's a cool paper where they had people swallow a pH transmitter, look at fig for healthy people, you see how the pH changes through the jouney and ends with a fecal pH, median reading about 6.5.

http://www.salix.com/healthcare-professionals-resources/gi-digest-newsletter/gi-digest-archive/index/intraluminal-ph-in-ulcerative-colitis.aspx

Hope that helps!

Shawn B. said...

Thanks Tim and Grace for everything you've been posting -- there is some tremendously useful information here.

I was hoping you could elaborate on the rationale for psyllium. I understand it's supposed to shuttle RS to the distal colon. However, as you increase the dose of resistant starch, you begin to recover undigested starch in the stool. That means, RS is reaching the distal colon in quantities large enough to completely saturate the distal colonic flora's ability to metabolize it. Why not simply increase dose of RS until that occurs?

The other thing that makes me question the value of psyllium for SIBO or dysbiosis is its lack of specificity. Wouldn't it be safer to restrict broader-spectrum prebiotics until you have weeded out the pathogens with SBO's / resistant starch / anti-microbials?

Thanks,
Shawn

Tim Steele said...

Shawn B. - Good observations. From the studies and even real-life experiences, it seems pretty important to add an additional fiber-type to the potato starch.

Approximately 25% of people can't metabolize potato starch, presumably due to gut flora dysfunction. Adding in another fiber will 'spread the odds' that gut flora is getting fed.

Also, as you eluded, psyllium has been shown to bind up some of the raw starch and allow it to be spread over the entire colon, kind of like a timed-release feature, and it may not be as simple as just eating more potato starch until complete flooding is obtained that way. There seems to be a synergistic effect with RS and other fermentable fibers, also remember we are shooting for gut flora diversity, not just a gut with bugs capable of degrading potato starch.

I'd recommend trying different things out, seeing what works for you and reading all you can on the subject, you just might find a combo that works better for you based on the gut bugs you have and your own unique microbiome.

Hope that answer wasn't too lame!
Tim

JoBlue said...

I have a friend that is undergoing chemo and radio therapies to shrink a tumour in her colon (near the rectum). Later, she will have the remaining tumour removed surgically. Followed by a tie-off and a colostomy bag for a period of some months. At least, thats what the current care plan is.

I'm imagining her cages are pretty decimated at this point. As she approaches her final week of this stage of the treatment, I'm thinking she needs some good gut therapy to ensure she remains healthy until the surgery...but gentle, perhaps, at this point?

She has been on PS in her morning smoothie several times per week for several weeks. Im thinking that she needs a good probiotic soon, something with lacto and bifidos for a few weeks. SBOs are contraindicated, based on what youve said about compromised immune systems. And as soon as she has surgery, she will have a bag.

What would you recommend in her case? For now, until her surgery, then as she relies on the colostomy bag, and then after she returns to using her colon? I am very interested in her doing well, out of sheer compassion for another human being - this is such a terrible experience to be going through - and because i partake in the flora that feeds on hers. We all lick butt. Consensually; we are all in this together. :) And as selfish as it may sound, i don't want to lose all the hard work i've been doing on my own gut health.

What are your thoughts on a good course of action for someone in a similar situation? I would like to keep all three of us as healthy as we can be.

Tim Steele said...

JoBlue - Yes, you need to help save your friends butt.

Print this off and show it to her doctors: http://gut.bmj.com/content/61/Suppl_2/A93.1

Not sure if it's available, but sounds like a good option. Also they can flood the unused rectum with butyrate to do the same thing as the resistant starch suppositories described in the link above.

Ultimately your friend is now 'in the system' and has to rely on doctors to save her life. When she pulls through and starts to get strong, I would recommend all the probiotics you can find with different names of bacteria on them. There are lots. Just be careful, as you said, about the ones not recommended for those with compromised immune systems as she will have coming out of surgeries.

Grace's bionic RS smoothie should be on her daily menu, even now, or something similar, if she can have it.

Go to your local hippy health food store or on-line and buy some inulin, pectin, and glucomannan powders and put some of those in her smoothies as well. Even some bee pollen and Larch AG (arabinogalactin) if you can find it. No need to overwhelm, just a tsp of each or so, and can be split throughout the day.

Maybe get her started before the surgery to make sure she's not allergic to anything..better to find out now while she's still strong.

Hopefully Grace will chime in here if I've given you any bad advice, but I think with a friend like you, you will all be back to laterally transferring microbes soon enough. Best of luck to all involved. Give us updates!

Dr. B G said...

Thx Tim!

Hi JoBlue~
It is so heart breaking for me hear your story. Stay strong. I would love to hear your friend's progress.

Many probiotics can be helpful but unfortunately while the immune system is low from medical treatment, drugs, low spirits, surgery, chemo, antibiotics, etc, the safety of many probiotics incl Bifido and Lacto are questionable. The danger is that the probiotic will breach into the blood and cause a blood born infection (which may be harder to treat than the cancer).

What I know about cancer is limited but don't ignore the mind-body connection -- you sound so loving, positive and inspiring and I believe these are of the most powerful and potent healing forces.

When you're friend's immune system is more competent consider sharing with your medical 'team' the below. This was forwarded by Richard N at FTA which is mind blowing. It is the strain (not necessarily the same used in the studies, sorry -- I dunno) indicated in the Möse and Möse studies. Generally speaking C butyricum is a particularly anti-inflammatory, high butyrate producing human gut commensal baceria (and soil based probiotic).

http://blogs.scientificamerican.com/guest-blog/2010/11/03/bacteria-the-anti-cancer-soldier/?print=true

JoBlue said...

Huge props to both you, Grace, and you, Tim, for all the work you do! And to have us all giving good gut health to the ones we love...

I really appreciate your thoughts for my friend. When i read your response, Grace, I realized that I hadn't taken into consideration that the treatments - and all the resulting diarrhea - have probably resulted in a leaky gut. And that introducing any bacteria would probably be a bad idea at this point. I tend to think bacteria=good these days; forget that's not always true. So thank you for that reality check!

When her immune system is building again, you can bet I'll be working on her gut, building strength and then diverse bacteria, just as you say, Tim. But I guess that will be a while yet - until her resection heals and she is back to using her own system in its entirety. Who knows? Maybe we'll all know even more by that time.

Thank you both for your help!

Anonymous said...

Help! having been on a search for a cure for IBS-c for the last 2 years, had finally settled on a Perfect Health type diet (after succumbing to thinning eyebrows hair loss etc from VLC). Going gluten free cured all my upper GI probs. Having still little lingering problems I read taterot avidly on MDA and free the animal and decided to try the PS with chia seeds and probiotics. I gradually increased and introduced kefir and sauerkraut. i did feel better lots of good sleep and energy - however some bowel issues got a bit worse, but the biggest thing is i constantly itch! Urticaria is something I have had episodically but has been much better since I had changed my diet. I then went all these histamine intolerance sites, saw what probiotics increased histamine and saw that I was taking l.bulgaricus one of the worst offenders, as well as the probiotic foods. I now don't know how to proceed. I had been trying to source prescript- assist here in scotland before this all flared up but now don't know whether to carry on with the resistant starch experiment until I get the histamine under control? Some of the stuff i was reading suggested the RS might be feeding my own histamine producing gut bacteria. Am really at a loss as to how to proceed, as felt so keen to try the whole RS experiment- Tatertot you are so convincing!

Tim Steele said...

Anon - Have we been talking on MDA? I can't recall who you are..

No matter, sorry if my convincing tone got you in trouble, maybe I should start a new career as a drug dealer.

My advice with potato starch from the beginning was just to highlight a prebiotic substance that feeds gut bugs and was shown in hundreds of studies to produce favorable results to certain biomarkers of gut health.

Unfortunately (or fortunately), it's turning into a bit of a litmus test for people who have really big problems. The average Joe can just add some RS to the diet and be healthier for it, but, the vast majority who are looking at potato starch to cure their longstanding gut issues have more going on than the 'white powder' can cure. Grace likes to call it "feeding empty cages", but some people even may have full cages--they are just full of vipers!

I think folks like you need prebiotics worse than most, but until you figure out what is growing that shouldn't be, or what is completely missing, you may just be spinning your wheels, and that is super-frustrating to all of us.

I hate to sound like a broken record, but you need to get a good test of your gut microbes that will show yeasts and pathogens and all the other markers that someone can look at to make informed decisions. Not sure how possible that is on your budget or locale, but it will be worth it for you to explore.

Otherwise, you'll just have to keep trying things like you are and hope you find the right combination. You could start completely over, go on a zero FODMAP diet for a few weeks, see what happens, then reintroduce probiotics and prebiotics, but, you are probably pretty tired of all that by now. Sorry I couldn't be more help! Maybe Grace has some ideas.

clare said...

Thanks Tatertot for quick response, I didnt mean to accuse you of being drug pusher, just all the psychadelic dreaming people had talked of FTA tempted me to try PS! I haven't posted on MDA just a lurker. will have a look and see where in the UK I can get some testing done. Thanks again for advice

Anonymous said...

Tim - I have been wondering about other fiber sources besides psyllium. I have acacia fiber and I'm wondering if it is any good for feeding the good guys?

Ann

Anonymous said...

Dr. BG - I'm wondering how long I should be taking the SBOs before I really feel like it's kicking any fungal issues I have to the curb. I am taking the Prescript Assist, AOR P3, and Primal Defense Ultra for about three weeks now. I still have days when I feel that my yeast is an issue - mostly anxiety, depression, and appetite issues, not many sugar cravings, but headaches, shortness of breath, and just feeling fatigued and lousy. I started adding in about 100 to 150 grams of carbs per day a la Richard and Tim, in the form of sweet potato and rice. Haven't done beans yet, but that's next. I have issues with potato, so haven't added those in at this point, but maybe further into my recovery (leaky gut). I am also using Richard's smoothie with less fruit and an avacado added, and I'm using greens and Plantain flour, sometimes some tapioca starch, for the RS. I'm eating my own sauerkraut, raw kimchi, and occasionally some kombucha, jun, and water kefir. I'm wondering if I should cut back on the carbs because of the candida? I sort of felt like I had it under control with low-carb (just meat and veg) and no sugar, and since adding in the rice and sweet potatoes and the morning smoothie, I'm feeling some of the candida symptoms returning. Can just the RS, the SBOs, and the ferments kill my candida and help my gut bugs without feeding them the carby foods? I think the added carbs this past month have helped some of my other issues, but worsened my candida some. I'm sort of between a rock and a hard spot on this one. What to do?

I know you mentioned you had candida issues as well - how long were you doing RS and SBOs before you really felt that you'd kicked the candida? Is it just a time thing? I feel like it's not as severe as die-off, and that's why I'm wondering if the candida is getting worse?

Do you have an opinion on the caproyl, psyllium husk, and bentonite program that The Whole Approach advocates?

Thanks in advance Dr. BG!!

Ann

Anonymous said...

And Dr. BG - I should also add that I had the GI Effects stool test done and they found no "significant" fungus.

Thanks!

Ann

Jason Ljunggren said...

How about konjac can it be used as an alternative to psyllium? i know you listed other plant i was wondering if you were familiar with this ancient product?

Dr. B G said...

Anon,

You've fallen for the Pied Piper of the Arctic snow... lol!!

Histamine degrading microbes include the soil based ones in Rx Assist and the others. L. gasseri may also be one -- I use Flora Mend by Thorne and it includes that strain. Bifidobacter (another soil based Actinobacter) is another.

Constipation is (1) dysbiosis and (2) overgrowth of methanogenic bacteria. These can be crowded out by probiotics + feeding them. Please let us know your progress!

Dr. B G said...

Clare, Thx!

Ann, Acacia is fine. Glucomannan, modified citrus pectin, konjac and kudzu root, inulin and other oligosaccharides and many others work well as well. Start low and go slow is a motto that I like.

Jason,
Love konjac and the other ancient asian herbal kudzu (or kuzu). We are so lucky to have them in our tool kit for guarding gut health.

Dr. B G said...

Ann,

Love ur questions and comments! When did you have the GI 2200 done? Was it after the recent GI interventions? It's odd that no fungi was found. What are your thoughts on that?

"Do you have an opinion on the caproyl, psyllium husk, and bentonite program that The Whole Approach advocates"

I believe in weed weed weed WEEDING. Our guts are just so amputated, maimed and missing parts... They are overrun with yeasts and other parasites gone wild without the commensal strains to exert peace and tranquil control. What is your mercury situation?

My yeast did not clear until all the mercury and titanium hardware was removed. Sorry -- yes it's a rather significant intervention. For me and my kids, we have COMT and other gene variants that preclude healthy detoxification of most modern toxins...

What are you doing for the yeasts?

The strategies that help eliminate candida synergistically together are
--getting rid of mercury
--probiotics (L plantarum, Bifido, SBOs, S boulardii, etc)
--fueling and feeding the commensals (glucomannan, RS, soluble fiber, g banana flour etc)
--charcoal, clay
--exercise (this improves the commensal populations)
--biofilm busters
--weeding them -- coconut oil, botanicals, nystatin/fluconazole, biocurcumin, oregano oil, etc

Anonymous said...

Question for the collective brain trust: Is there any rhyme or reason why a dysbiotic person would respond to vitamin C supplements the way they do to fiber
( bloating/distention)?
Webraven

Shawn B. said...

Webraven-

At higher doses, vitamin C has an osmotic laxative effect, accelerating intestinal transit. When food passes through the intestines faster than it can be completely digested, fermentation of the remaining food can produce gas and bloating.

Webraven said...

Hi Shawn B,
You're right, that is how it would normally work. But for me, even the smallest amount of supplemental vitamin C, e.g. 1/16- 1/24 tsp of mineral ascorbates causes bloating, without any change in transit time. Perhaps it is just somehow irritating to an inflamed gut, but I do wonder about the tiny amounts needed to create a lot of bloating. I've tried liposomal products ( and every other kind under the sun :-) ), but they all have the same effect. Thanks for commenting!